Abstract
D.Cur. (Nursing Management)
A health maintenance organisation (HMO) that implements managed care is the health care service provider for a mine group. Case management is an integral part of managed care. Case management in a managed care setting within this mine group should be to the holistic benefit of both the client/patient and the service provider. Within the case management environment, nurse case managers (CMs) and their counterparts (professional nurses) should provide and facilitate quality patient care. However, they face many challenges, such as working in isolation from one another.
The purpose of the study was to develop a training programme for CMs and professional nurses (PNs) to facilitate quality patient care in a managed care environment for the health care service provider for a mine group. In this study a qualitative, exploratory, descriptive, and contextual design was followed. Purposive sampling was conducted from the populations of six CMs (N=6) and thirty PNs (N=30). Focus group discussions with twenty-eight (28) PNs and individual unstructured interviews with four (4) CMs were conducted to describe their experiences in the case management environment. Open coding followed, based on Tesch’s (1990) method of qualitative analysis (De Vos, 1998:343), and a conceptual framework emerged from the data analysis. A programme to facilitate quality patient care in a case management environment of the HMO was described for stakeholders (nurse case-managers and PNs). Recommendations for implementing the programme were described.
Adapted phases of the programme development process of Meyer and van Niekerk (2008) were used in developing the programme. The survey list of the Practice Oriented Theory of Dickhoff, James and Wiedenbach (1968:434) formed the basis for developing a conceptual framework for the programme. Principles of case- and problem-based approaches (Scheider, 2010) served as a point of departure to develop the context-specific training programme.
Trustworthiness was maintained by using Guba’s (De Vos, 2006:346; Babbie & Mouton, 2001: 276) model criteria, which are credibility, transferability, conformability and dependability. Ethical standards were adhered to throughout the study.