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Biomedical subjects

J B Doerge

Publications and source records attributed to J B Doerge.

2 recordsLinked to original sources

Integrating care delivery.

Mergers and acquisitions, multibillion dollar profit margins, and hospital chains that boast more than 400 sites all reflect the fact that health care is no longer a cottage industry but a corporate giant. The forms and structures that will provide care will continue to disintegrate and then evolve as we face a crisis in Medicare funding and as the ranks of uninsured continue to grow. The challenge for nursing leaders to stay centered on the core product and the core process of our industry--caring for patients. Integration is the key strategy that must be applied to achieve that end. We must strive for integration in three levels: within ourselves, between persons, and within our organization. Only then will nursing leadership be able to bring wholeness and influence to the corporate health care world through our individual roles and collectively through our profession.

Delivery of Health Care, Integrated↗

Creating an outcomes framework.

Four constructs used to build a framework for outcomes management for a large midwestern tertiary hospital are described in this article. A system framework outlining a model of clinical integration and population management based in Steven Shortell's work is discussed. This framework includes key definitions of high-risk patients, target groups, populations and community. Roles for each level of population management and how they were implemented in the health care system are described. A point of service framework centered on seven dimensions of care is the next construct applied on each nursing unit. The third construct outlines the framework for role development. Three roles for nursing were created to implement strategies for target groups that are strategic disease categories; two of those roles are described in depth. The philosophy of nursing practice is centered on caring and existential advocacy. The final construct is the modification of the Dartmouth model as a common framework for outcomes. System applications of the scorecard and lessons learned in the 2-year process of implementation are shared

Case Management↗