Impact of the Registered Nurse Clinical Liaison Role in Ambulatory Care on Transitions of Care: A Retrospective Cohort Study.

ABSTRACT

PURPOSE OF STUDY To determine the relationship between engagement with the novel register nurse care liaison (RNCL) and enrollment in care management compared with usual care in hospitalized patients. PRIMARY PRACTICE SETTING: Patients in the hospital from January 1, 2019, to September 30, 2019, who would be eligible for care management. METHODOLOGY AND SAMPLE This was a retrospective cohort study. The authors compared a group of 419 patients who utilized the services of the RNCL at any time during their hospital stay with the RNCL to a propensity matched control group of 833 patients, which consisted of patients who were hospitalized during the same time as the RNCL intervention group. Our primary outcome was enrollment in care management programs. Our secondary outcome was 30-day readmissions, emergency department (ED) use, and office visits. The authors compared baseline characteristics and outcomes across groups using Wilcoxon-Mann-Whitney and χ2 tests and performed an adjusted analysis using conditional logistic regression models controlling for patient education and previous health care utilization. RESULTS: The authors matched 419 patients who had engaged an RNCL to 833 patients in the usual care group; this comprised the analytic cohort for this study. The authors found 67.1% of patients enrolled in a care management program with RNCL compared with only 15.3% in usual care (p < .0001). The authors found higher rates of enrollment in all programs of care management. After the full adjustment, the odds ratio for enrollment in any program was 13.7 (95% confidence interval 9.3, 20.2) for RNCL compared with usual care. There was no difference between groups with 30-day hospitalization or ED visit. CONCLUSION: In this matched study of 419 patients with RNCL engagement, the authors found significantly higher enrollment in all care management programs. IMPLICATIONS FOR CASE MANAGEMENT PRACTICE These findings encourage further study of this care model. This could help enhance enrollment in care management programs, increase relationships between inpatient practice and ambulatory practice, as well as increase communication across the continuum of care.