Despite the level of organizational investment in training and performance improvement, little is known about the use of different models of case management as interventions for the ever-increasing health care issues in the United States. Based on Van Tiem, Moseley, and Dessinger's Performance Improvement/Human Performance Technology model, this case study used qualitative semi-structured interviews and quantitative archival aggregate patient data to answer the following research questions: RQ1. How did the implementation of the triad model of case management process improvement change case management processes and implementation methods? RQ1a. What happens to key performance indicators (cost of service, patient satisfaction, and quality of care) when the triad model of case management process improvement is implemented? RQ2. How did acceptance and resistance to a new case management model manifest themselves during the implementation of the triad model of case management process improvement intervention? Seven hospital employees answered questions regarding possible resistance to change during the implementation phase of this model of case management. Data analysis included comparisons of the participants' responses regarding cost of care, quality of care, and satisfaction with services to quantitative archival measures of those variables. Mean comparisons of all three areas, cost of service, quality of care, and satisfaction with services, revealed that differences before and after implementation of the triad model were not significant .for cost and satisfaction with services, but were significant for quality of care positively post the implementation. Participant interviews provided general indications that cost of service, quality of care, and satisfaction with services improved with the intervention of the triad model of case management. Participants generally also approved of the change to the triad model of case management following an initial period of concern about work disparity, which resolved with the separation of utilization review and case manager job duties. Recommendations for future research include waiting beyond the time frame used in this study to assess for change and further evaluating possible resistance to change in an organization using emerging trends in human performance technology (HPT) and the completed HPT process. Additional recommendations based upon current research include adding employee well being to cost, quality of care, and satisfaction with services in an integrated model of case management.
|Commitee:||Robinson, Pamela, Van Tiem, Darlene|
|School Location:||United States -- Minnesota|
|Source:||DAI-B 79/12(E), Dissertation Abstracts International|
|Subjects:||Nursing, Organizational behavior, Health care management|
|Keywords:||Case management, Hospital case management, Human performance technology, Human performance technology model, Performance improvement, Triad model of case management|
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