Quantifying case management workloads: Development of the PACE tool.

In 1999, the Clinical Resource Management (CRM) group at Saint Alphonsus Regional Medical Center in Boise, Idaho, implemented a specialty-based nursing case management model for individual caseload assignment of all inpatient admissions. This model assigns caseloads by proportion determined by physician specialty type. This model does not consider patient acuity and may have weaknesses associated with self-report. In addition, time requirements for effective case management outcomes are not always reflected in admission volumes alone. This article describes the development and pilot testing of the Patient Acuity Case management Evaluation (PACE) measurement tool. Five phases of methodological development are discussed: (1) conceptualization phase, (2) content development, (3) Delphi technique using expert opinion and critique, (4) inter (intrarater reliability testing, and (5) pilot testing of acuity tool. Examples of instrument development throughout these phases are included. This instrument is expected to provide verifiable measurement of individual and group case management workload.