Transforming the Workforce to Provide Better Chronic Care: The Role of a Behavioral Health Nurse Care Coordinator in Minnesota
Part 3 in the Transforming the Workforce to Provide Better Chronic Care:
The Role of Registered Nurses series.
Click to see the rest of the series.
Hennepin Health, a safety-net accountable care organization in Minnesota, has begun to integrate primary care into Hennepin County Mental Health Center through a behavioral health nurse care coordinator. The behavioral health nurse care coordinator ensures her patients’ care is comprehensive and coordinated by doing complete assessments of patients’ medical health, behavioral health, and social needs, as well as providing basic on-site medical triaging and patient education.
In addition to highlighting state policy implications, this brief also showcases how Amber Morgan, the behavioral health nurse care coordinator, is able to drive improvements in care for her patients. Since hiring Amber, early data has shown that inpatient hospitalizations and the use of the emergency department among behavioral health patients have decreased.
This brief is the third in a six-part series, supported by the AARP Public Policy Institute, which explores the evolving role of nurses in new delivery system models.
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For individuals living with complex, often chronic conditions, and their families, palliative care can provide relief from symptoms, improve satisfaction and outcomes, and help address critical mental and spiritual needs during difficult times. Now more than ever, there is growing recognition of the importance of palliative care services for individuals with serious illness, such as advance care planning, pain and symptom management, care coordination, and team-based, multi-disciplinary support. These services can help patients and families cope with the symptoms and stressors of disease, better anticipate and avoid crises, and reduce unnecessary and/or unwanted care. While this model is grounded in evidence that demonstrates improved quality of life, better outcomes, and reduced cost for patients, only a fraction of individuals who could benefit from palliative care receive it. 























































































































































