Date of Award

Spring 1988

Degree Type

Thesis - Restricted

Degree Name

Master of Science (MS)

Department

Nursing

Abstract

Recent changes in health care financing have created increased emphasis on cost-containment in hospital provided services. Health maintenance organizations promote efficient health care by offering professional services for a set, reasonable fee . Emergency Services are a target for cost-containment measures and emergency nurses often are placed in gatekeepers roles. Cost effective and appropriate decisions on use of emergency services depends upon clearly defined patient protocols, utilized by the HMO and emergency nurses. Standards of care have been established for emergency nurses and are defining components of quality of care. Issues arise when HMOs define quality in cost savings and emergency nursing define quality in patient outcomes. These issues are addressed by strategies found successful in three Milwaukee emergency departments.

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