Lessons Learned from Testing the Quality Cost Model of Advanced Practice Nursing (APN) Transitional Care

Authors

Dorothy Brooten, Nicole Wertheim College of Nursing and Health Sciences, Florida International UniversityFollow
Mary D. Naylor, University of Pennsylvania
Ruth York, University of Pennsylvania
Linda P. Brown, University of Pennsylvania
Barbara Hazard Munro, Boston College
Andrea O. Hollingsworth, Gwynedd Mercy College
Susan M. Cohen, Duquesne University
Steven Finkler
Janet Deatrick, University of Pennsylvania
JoAnne M. Youngblut, Nicole Wertheim College of Nursing and Health Sciences, Florida International UniversityFollow

Date of this Version

2002

Document Type

Article

Abstract

Purpose

To describe the development, testing, modification, and results of the Quality Cost Model of Advanced Practice Nurses (APNs) Transitional Care on patient outcomes and health care costs in the United States over 22 years, and to delineate what has been learned for nursing education, practice, and further research.

Organizing Construct

The Quality Cost Model of APN Transitional Care.

Methods

Review of published results of seven randomized clinical trials with very low birth-weight (VLBW) infants; women with unplanned cesarean births, high risk pregnancies, and hysterectomy surgery; elders with cardiac medical and surgical diagnoses and common diagnostic related groups (DRGs); and women with high risk pregnancies in which half of physician prenatal care was substituted with APN care. Ongoing work with the model is linking the process of APN care with the outcomes and costs of care.

Findings

APN intervention has consistently resulted in improved patient outcomes and reduced health care costs across groups. Groups with APN providers were rehospitalized for less time at less cost, reflecting early detection and intervention. Optimal number and timing of postdischarge home visits and telephone contacts by the APNs and patterns of rehospitalizations and acute care visits varied by group.

Conclusions

To keep people well over time, APNs must have depth of knowledge and excellent clinical and interpersonal skills that are the hallmark of specialist practice, an in-depth understanding of systems and how to work within them, and sufficient patient contact to effect positive outcomes at low cost.

Comments

Post Print Version.

The publisher's final edited version of this article is available at J Nurs Scholarsh

Recommended Citation

Brooten, Dorothy; Naylor, Mary D.; York, Ruth; Brown, Linda P.; Hazard Munro, Barbara; Hollingsworth, Andrea O.; Cohen, Susan M.; Finkler, Steven; Deatrick, Janet; and Youngblut, JoAnne M., "Lessons Learned from Testing the Quality Cost Model of Advanced Practice Nursing (APN) Transitional Care" (2002). Nicole Wertheim College of Nursing and Health Sciences. 29.
https://digitalcommons.fiu.edu/cnhs_fac/29