Paper
Wednesday, 19 July 2006
This presentation is part of : Advanced Practice Nursing Initiatives
Cost Effective and Revenue Generating Activities of Clinical Nurse Specialists
June L. Rondinelli, BSN and Anna Omery, RN, DNSc. Patient Care Services, Kaiser Permanente, Pasadena, CA, USA
Learning Objective #1: Describe the thematic activities that Clinical Nurse Specialists identify as cost effective and revenue generating.
Learning Objective #2: Identify themes that Clinical Nurse Specialist describe as both cost effective and revenue generating activities.
The purpose of this descriptive, qualitative study was to describe the activities that CNSs identify as cost effective and revenue generating.  Nine hundred forty five (945) Clinical Nurse Specialists responded to a multi-part survey mailed to all California Board of Registered Nursing-certified Clinical Nurse Specialists.  Themes were developed through content analysis of responses to open ended questions on the survey.  Two hundred and four (204) cost effectiveness activities were categorized into eighteen themes. Eight-two (82) revenue generating activities were categorized into 11 themes.   Randomly chosen exemplars were presented to expert judges to validate themes.  The cost effective thematic categories were as follows:  identifying and evaluating current financial costs (16%), evaluating and analyzing data related to current services and research (16%), program development and management (7.4%), developing and monitoring outcomes (7.4%), decreased length of stay (7%), coordination of care (7%), satisfaction and retention of patients and staff (7%), teaching and mentoring (6.1%), visit utilization (5.4%), quality improvement (4%), collaboration/consultations (3%), expert skills/therapy (3%), developing and implementing best practices (2.5%), active participation in professional organizations (1%), committee participation (1%), managerial activities (1%), preparation and review of contracts (1%), and other (4%) which includes general statements supporting the CNS role and its cost effectiveness.  The revenue generating thematic categories were as follows: education (23%), research (14.6%), assessments (14.6%), program development and management (9.7%), out-patient visits (8.5%), billing (6%), products development and evaluation (4.8%), nurse practitioner activities (4.8%), expert skill and therapy (4.8%), private practice (2%), and other (6%).   Four themes that cut across cost effectiveness and revenue generating activities were research, programs, education, expert skills and therapy.  CNSs report multiple ways that they are demonstrating cost effectiveness and generating revenue.   The activities that they report are consistent with the clinical leadership role.  Yet, only 22% of the respondents reported these types of activities. 

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