TY - JOUR
T1 - Guided care :a new frontier for adults with chronic conditions
AU - Aliotta, Sherry L.
AU - Grieve, Kathleen
AU - Giddens, Jean F.
AU - Dunbar, Linda
AU - Groves, Carol
AU - Frey, Katherine
AU - Boult, Chad
PY - 2008/5
Y1 - 2008/5
N2 - Purpose: This article describes "Guided Care," a promising new model of case management that includes disease management, self-management, transitional care, and caregiver support for multimorbid patients and their families. Primary Practice Settings: Guided Care nurses, based at primary care practices, extend services to the home and all the other settings where their patients receive care. Findings and Conclusions: Guided Care nurses take responsibility for 50-60 multimorbid patients. For each patient, the nurse performs a home assessment and creates an evidence-based plan of care. In partnership with the primary physician, the Guided Care nurse then monitors and coaches the patient monthly, coordinates the patient's transitions between providers and sites of care, educates and supports family caregivers, and facilitates access to community resources. Implications for Case Management Practice: As a next stage in the evolution of case management, Guided Care may be supported by Medicare and, therefore, adopted widely throughout the American healthcare.
AB - Purpose: This article describes "Guided Care," a promising new model of case management that includes disease management, self-management, transitional care, and caregiver support for multimorbid patients and their families. Primary Practice Settings: Guided Care nurses, based at primary care practices, extend services to the home and all the other settings where their patients receive care. Findings and Conclusions: Guided Care nurses take responsibility for 50-60 multimorbid patients. For each patient, the nurse performs a home assessment and creates an evidence-based plan of care. In partnership with the primary physician, the Guided Care nurse then monitors and coaches the patient monthly, coordinates the patient's transitions between providers and sites of care, educates and supports family caregivers, and facilitates access to community resources. Implications for Case Management Practice: As a next stage in the evolution of case management, Guided Care may be supported by Medicare and, therefore, adopted widely throughout the American healthcare.
KW - Case management
KW - Chronic disease
KW - Multimorbidity
KW - Nursing
KW - Primary care
UR - http://www.scopus.com/inward/record.url?scp=50349085979&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=50349085979&partnerID=8YFLogxK
U2 - 10.1097/01.PCAMA.0000319968.76605.b3
DO - 10.1097/01.PCAMA.0000319968.76605.b3
M3 - Article
C2 - 18562909
AN - SCOPUS:50349085979
SN - 1529-7764
VL - 13
SP - 151
EP - 158
JO - Professional Case Management
JF - Professional Case Management
IS - 3
ER -