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This article is the second in a series supporting the business case for care coordination and transition management (CCTM) in health care. The series will support nurses in building business cases that create a positive return on investments and leverage nurses in CCTM or other roles within the healthcare continuum. A business case template was developed to support nurses seeking to transform care and serve as a guide for creating a business case for CCTM.
The healthcare delivery system is transforming from a fee-for-service, segmented, episodic, acute focus to one emphasizing continuous value across a patient's life and the healthcare continuum, focusing on health promotion and disease prevention (American Hospital Association, 2018; Berwick et al., 2008; Schneider et al., 2017). The Quadruple Aim underscores the importance of better outcomes, lower costs, improved patient experience, and improved clinician experience as the foci of current initiatives to achieve this critical transformation to continuous value (Feeley, 2017).
Nursing as a profession has always held a holistic view of the patient. Still, now it is imperative nursing understands the value mandate and leverages this view to contribute to the transformation to continuous value. Creating interventions that improve health, advance equitable and accessible care, and engage patients in designing their health plan are fundamental nursing approaches. Registered nurses (RNs) across the healthcare continuum must be able to articulate business case outcomes when leveraging the role of the RN and other interprofessional team members in care coordination, population health, transition management, and other value-based transformation activities (Haas, Conway-Phillips et al., 2019; Start et al., 2020). Business case outcomes may be realized for improvements in health outcomes; decreased cost for healthcare organizations or consumer affordability; access to healthcare, consumer, or staff experience; or removal of social determinants that obstruct health - the Quadruple Aim.
In the first article in this series, Start and colleagues (2020) provided a thematic analysis of care coordination and transition management (CCTM). This article is the second in a series supporting nurses to understand the importance of Care Coordination and Transition Management (CCTM) in healthcare focused on value. The series aim is to support nurses in crafting business cases that create a positive return on investments that leverage nurses in CCTM or other roles within the continuum...