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Evolution of a role to enhance care coordination.

The recent trend toward shorter hospital stays has prompted health care personnel in acute care settings to reevaluate models of coordinating patient care. In whatever model is adopted, there must be someone whose role is to focus on achieving quality patient outcomes in a shorter time frame. Our institution has piloted several different models with various job classes to fulfill the role. However, the primary focus of the models-to enhance care coordination-remained unchanged. The initial care coordination model was the development of patient care coordinator role by converting the charge nurse position on the unit. The second model our institution developed occurred during a management restructuring. This model created a new position, a nursing practice coordinator, who had previously been a management support person with supervisory responsibilities. We now envision the role to be assumed by a nurse practitioner. The nurse practitioner's broader scope of practice potentially can further enhance coordination of care. In this article, the authors describe the development process, issues and interventions, and lessons learned during each step of redesigning a case management model.