2. ACUTE CARE/ILLNESS CARE INCREASINGLY BEING DELIVERED IN THE HOME/COMMUNITY SETTINGS A. RATIONALE/BASES: Early Hospital Discharge due to: Lncreasing Costs of Hospital care/ Services ; Insurance Requirements etc. Increasing Burden of Chronic and Palliative Care By 2010 in the USA: 70% to 80% of illness care delivered in the home setting B. CHALLENGES/CR. EA TIVE OPTIONS Expertise/Comp etence on specific areas in Acute Care in the Home setting Case f>v{anagcment as nucleus of the of the continuum of care with the nurse case manager as orchestrator of services in precise and synchronous fashion thru the use of critical pathways, care maps and disease managemlnt protocols to identify key events that must occur to achieve outcomes and ensure patient progressio n through restoration/maintenance gnals. Nurse's roles vary from monitoring lo~g-tenn needs of enrollees of managed care to managing current episode of care (Lundy and James 2001: 144). Effective Use of the Two-Way Referral System Enhancing the Empowering Potential of Families on Acute/Ulness and Palliative Care to Prevent or Reduce Care Burden Enhancing Nursing Clie11ts' Healthy Tr:rnsitions to address sudden role chnn~es that result from moving from a wellness state to an acute i\\ness, from wellness to chronic illness or from chroniclty to a new wellness that encompasses the chronicity (Me\eis 2007: 471). 3. FOCUS ON CARE OF POPULATION AGGREGATES TO PROMOTE HEALTHY TRANSITIONS A. RATIONALE/DASE S: Population Shifts Increasing number of healtl1 care needs/problems of older popu Jation. ethnic and other mnrginnli1. ed groups Emphasis on chl\d and adolescent health. reproductive health/ women's het\llh Increasing scope, magnitude, 11nd impact of natuml and human-induced disasters around the world (ICN 2006). I 