The health care delivery environment is well into a period of dynamic transition. Important aspects of this transition involve changes in both the way health care delivery is managed and changes in the roles of health care provider groups in the management and delivery of care ("Case management," 1993, pp. 117-123). Integral to the changes occurring in the contemporary health care delivery environment are the increased emphases on care quality and patient satisfaction (Schweikart, 1996, pp. 19-36). This study investigated the relationships between these several factors.
Health care organizations are implementing new patient care delivery models with the expectation that operations reengineering will bring dramatic improvements in cost, quality, and patient satisfaction (Schweikart, 1996, p. 19). Together with the fundamental redefinition of caregivers' work roles, the adoption of reengineering principles features the organization of work activities around team structures such that teams are considered the basic unit of work performance. This revised organizational structure is causing an increased emphasis to be placed on the application of the case management concept as a means of assuring care quality and economy in the delivery of care.
Improving the quality of the care provided is widely suggested in the 1990s as the solution to many of the problems being faced by health care institutions (Phipps, 1992, p. 10). While medical professionals have no quarrel with striving for high quality health care, many of these individuals do tend to reject initiatives that appear to be further manifestations of codified bureaucratic machinations that likely will have no long-lasting positive impacts on the quality of health care services (Jeffer, 1991, pp. 546-550). Nevertheless, many theorists and observers both inside and outside the medical establishment suggest that a quality management program can lead to improved quality in heal...