how the inadequacy of caseload management information from staff development and education programs, and nursing textbooks hinders quality and efficient nursing care to patients

how the inadequacy of caseload management information from staff development and education programs, and nursing textbooks hinders quality and efficient nursing care to patients

The goals of public health care providers, including nurses, are all geared towards the achievement of better health opportunities for the patients. One of the attributes that are required by healthcare administrators is caseload management who works with lots of different patients. The journal article “Caseload Management Skills for Improved Efficiency” by Naomi Ervin talks more about caseload management, which is one of a group of six competencies recognized by nurse administrators (Ervin, 2008). In the abstract, the author highlights how the inadequacy of caseload management information from staff development and education programs, and nursing textbooks hinders quality and efficient nursing care to patients. The article focuses on ambulatory and community settings despite the skill being useful in other settings (Ervin, 2008, p. 127). The article then expands on the skill while giving notable differences between care, case and caseload management, and their long-term goals. After the comparison, the author outlines and discusses the foundational skills needed for caseload management and the methods for caseload management.

Caseload management is the process where patients, also referred to as “cases” are organized to get the care and treatment they need. Based on a study on 363 nurse administrators, the article by Ervin defines caseload management skills as the “the ability to coordinate a specific number of clients” and may include direct care, which adds resource and time management (Ervin, 2008, p. 127). Caseloads may consist of a mixture of facilities and cases or individual schools, facilities, families, and patients. Calculations on the caseloads are normally combined with workloads since each case requires different amounts of time to solve. According to Ervin, “case management” or “care (disease) management” is normally confused with “caseload management” despite their differences (2008, p. 128). The author differentiates the three in a table. Caseload management processes mainly focus on the efficient use of time in the care of groups of patients while the case and disease management mainly focus on individual patients to achieve restoration and fiscal goals, respectively. Common elements between the three include the monitoring, evaluation, coordination and planning process, all focusing on improved patient outcomes.

Ervin further expounds on the three foundational skills provided in basic nursing preparation that is required for caseload management. These foundational skills include organization, priority setting, and coordination (2008, p. 128). Organizational skills are the basis for caseload management. This ability is important since it gives confidence to the nurses for their ability to organize and deal with a large number of cases, including the incorporation of home visits, among other activities. Development of these organizational skills commences with learning structures that students can use, such as planning each day, using a filing system, and keeping an updated appointment calendar, among others. Once implemented, this skill is relied upon heavily when they become nurses and have complex job assignments. The article suggests that this approach to building up organizational skills allows for a smooth transition once graduates become registered nurses who handle more responsibilities (Ervin, 2008, p. 129).

The second basic skill, priority setting, is fundamental when graduates assume their first positions. The article begins by articulating that setting priorities for individual patients is a different form of caseload management since the later can have three areas that require management (Ervin, 2008, p. 129). At the macro level, nurses need to have an understanding of the agency’s agenda, for it is the agencies that determine parameters nurses use in caseload management. The second priority level involves the planning of home visits accounting for every single day of the month. The third priority level outlines encompass rescheduling of the facility or home visits, which is aided by having a monthly scheduling calendar to spread out the visits to each patient evenly. Coordination, the last basic skill, promotes working together of people in various fields (Ervin, 2008, p. 129). Timely feedbacks, conferences, and scheduled communications between healthcare practitioners in different fields are some of the ways of how coordination takes place. The article suggests that in places where coordination mechanisms are not available, the nurses need to develop a system where information can bet shared effectively and regularly to aid in caseload management.

The article further discusses the methods used to manage caseloads, including caseload analysis, scheduling visits, and the tools used for caseload management (Ervin, 2008, p. 129). The author defines caseload analysis as the process used to examine the number and types of cases; new referrals received, age groups served, and emergency situations in need of immediate attention. Each analysis starts with a review of all cases by the supervisors and nurses, where each case is discussed and classified using the Easley-Storfjell instruments based on their visits and complexity. The author suggests that adjustments are necessary where caseload analysis reports show inadequate time for nurses to complete all tasks to prevent overburdening of the nurses (Ervin, 2008, p. 130). The second method, scheduling of home visits, varies depending on each case, especially when dealing with intensive home visits. These visits are important in helping to determine consequent visits while considering visits to other facilities or patients.

The use of tools to manage caseloads has increased in the past decade. Tracking systems have been accredited to be a key component in caseload management in the article (Ervin, 2008, 130). The tracking systems provide the structure needed to maximize the available time for each nurse while providing timely care to the patients. The author suggests keeping a tickler system that holds essential information of each family, arranged in order for the next visit. Nowadays, these files are stored in computer systems, which are easy to update. Computer software is beneficial in the tracking, for it can be used to set reminders for the next visits, follow-ups, and referrals. Besides being used to set reminders, tracking systems are essential tools for nurses working in ambulatory care settings because their caseloads are only specific to them.

In conclusion, caseload management, not to be confused with a case or disease management as per the article by Ervin, is a vital skill sought out by nurse administrators. Caseload management skill is highly dependent on three factors. Organizational skills and priority setting help in the planning of home visits, and complexities in patient’s problems, while coordination improves communication between nurses and people in other departments. In addition to having the basic skills, the article discusses methods used to facilitate caseload management, including the use of tracking systems used to update patients and their visits information. Caseload management, therefore, is important in basic and continuing nursing education.