Researchers: Gil Ziv¹, Shuli Brammli-Greenberg^2,3, Limor Chen¹

Background: The Ministry of Health recently devised a policy aimed at assimilating patient-centered practice. However, its application in the inpatient system was not determined. In the last 4-years, a case-manager nurse (CMN) model was implemented in the Otolaryngology Head and Neck Surgery Department and Neurosurgery Department at Rambam Medical Center.

Objectives: To examine the effectiveness of the CMN model in two surgery departments in a university hospital.

Method: A systematic mixed-study composed of retrospective and prospective case-control cohort and patient surveys. Outputs that affect cost-benefit ratios in both arms were measured and a univariate and multivariate analyses were used for statistical assessment of the data.

Findings: Efficiency and influence were found to be statistically significant, ENT department had saved 2,000 waiting days for surgery, 1130 re-readmissions and about 3,000 hospitalization days, at a cost of 61 NIS per patient. In the Neurosurgery department, with an annual cost of 217 NIS for one elective hospitalization, the satisfaction and service indices were improved significantly. As the number of elective patients increases, the more worthwhile the investment becomes with an almost negligible cost after the first 1000 inpatients

Conclusions: In both parts of the study, we demonstrated the utility and cost benefit of the CMN model in two department with different characteristics.

Recommendations: The CMN model can lead to increased efficiency and has the potential to improve patients' satisfaction and experience. Each department should develop a model that will fit its own needs and integrate the role of the CMN into it. The model should implement broad communication channels with the entire departmental staff including: nursing, medical and para medical teams, in order to maximized its impact on the system.

Research end date: 05/2020