utcomes, productivity, continuity of care, nurse satisfaction, and physician satisfaction" (Schweikart, 1996, p. 26).
To accomplish the objectives of improved care quality and patient satisfaction, while simultaneously controlling the costs of delivery of health care, acute care institutions are seeking to better manage their resources·financial, human, and physical. The use of nurse practitioners to deliver primary care in emergency care settings is one important action being implemented by acute care institutions in the pursuit of these objectives (Buchan & Powers, 1997).
The problem confronting acute care institutions in the contemporary period is how to use available resources with optimal effectiveness in the application of the case management concept in the pursuit of care quality and patient satisfaction. Nurse practitioners engage in the delivery of a wide variety of health care services without the direct supervision of physicians (Thibodeau & Hawkins, 1994). Frequently, the use of nurse practitioners in such roles has been found to
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