Implementation of a Managed Care Model in an Acute Care Setting

The center of attention in recent nursing literature has been on the evolution of outcome-based care. This concept has emerged as an array of models that includes patient-focused care, case management, and managed care. All these approaches to redesigning patient care have a basic goal: to deliver quality care in a timely manner by using appropriate resources. The program at St. Margaret Mercy Healthcare Centers focused on the staff nurse as the multidisciplinary team member who would be responsible for coordinating patient care. This type of model, in which the pathway is initiated at the staff level, is called managed care. Managed care, as defined by Zander, is unit-based care that is organized to achieve specific patient outcomes within fiscally responsible time frames or lengths of stay (LOS) while using resources that are appropriate in amount and sequence to the specific case type and to the individual patient (1988a).