Nurses to Expand Practice Roles in Coordinated Care Organizations Model
By Tara L. Gregory, MSNHA, FNP-BC, ONA Nursing Practice Consultant
For years, the professional nurse has been the leader and expert in acute care settings, community settings, and ambulatory care settings. This is an exciting time for nurses as new roles are emerging that will place nurses at the center of the care team. One of the objectives of the new Coordinated Care Organizations (CCO) is to provide high quality, well managed, coordinated and comprehensive care to a growing number of patients.
Nurses have the educational and experiential preparation to fill a number of emerging roles such as nurse navigator, who will help facilitate care transitions as patients discharge from a hospital or transition to a facility, or may help guide the patient along the path during specialized procedures or treatments. Nurse care managers will work together with patients and families to ensure that the patient has a central access point for advice about care and discuss what the patient and/or family can do as participants of the health care team. The nurse care managers have the training in health assessment and triage and can help the patient obtain appropriate guidance and monitoring, especially for patients with chronic conditions. The nurse can also help facilitate home health care, obtain needed equipment and supplies, and provide teaching as appropriate to the disease process.
Nurses in CCOs and Patient-Centered Primary Care Homes (PCPCH) will find a multidimensional model is used to deliver care to patients. Nurses may provide assessment and care through advice over the telephone. Proposed legislative activity may enhance nurse’s ability to provide nursing advice to patients in rural or remote areas using technology. Nurses will educate patients and families face-to-face in both ambulatory care settings and in the home setting. Nurses will coordinate care transitions so the patient has the most seamless experience with the greatest health benefit. The message here is clear: Nurses are well-suited to fill these current and expanding roles, providing increased opportunities to contribute to patient care in a variety of settings.