The perceptions of specialist nurses in delivering value-based integrated care

Karen Hutchinson, Andrea Smith, Tayhla Ryder, Marika Franklin, Sophie Lewis, Frances Rapport

Research output: Contribution to conferenceAbstractpeer-review

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Objectives: Specialist nurses’ roles are ideally placed to instigate, lead and drive system change (1). This project aimed to (a) clarify the role of specialist nurses in supporting person-centred and integrated care and, (b) inform the future role development and scope of the specialist nurse. Methods: Secondary analysis of in-depth qualitative interview data combined the views of epilepsy specialists nurses (ESN) (2)(n=12) and metastatic breast care (mBC) nurses (3)(n=15) and examined roles, value, and responsibilities in providing patient-centred supportive care in Australia. Thematic analysis used the constant comparison method, drawing on the Quadruple Aim (4, 5). Results: Nurses viewed their roles as bridging gaps in care delivery and providing holistic, integrated care in a timely, appropriate, ethical, flexible, and efficient way for individuals often marginalised by the complexities of their medical condition. Similarities existed in how the ENS and mBC nurses defined their roles as multi-faceted and encompassing advocacy, system navigation, care coordination, information provision, clinical, emotional, and instrumental support. Many nurses confirmed a shift in their role from clinical care to encompassing a biopsychosocial care model in accordance with patient need. Strong system knowledge across different sectors and settings, well developed interprofessional relationships, organisational support, professional unity, and extensive experience in clinical and psychosocial support assisted nurses in both roles to maintain their sense of professional identity. Yet there were critical differences spanning how each role was affected by different funding models, settings (clinical, community based), delivery modes (face-to-face, telehealth), role boundaries, patient demands and stakeholder understandings of nurse roles. Conclusion: The ESN and mBC nurse roles have evolved to provide condition-specific, person-centred, integrated care despite the considerable challenges associated with delivering this care. Greater role clarity, to support professional identity, may assist the ongoing development and advancement of specialist nurse roles in the provision of responsive integrated care.
Original languageEnglish
Number of pages1
Publication statusPublished - 27 May 2021
EventValue Based Health Care Conference - Perth , Australia
Duration: 27 May 202128 May 2021


ConferenceValue Based Health Care Conference


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