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ISRN Nursing
Volume 2013 (2013), Article ID 793936, 7 pages
Research Article

A Statewide Case Management, Surveillance, and Outcome Evaluation System for Children with Special Health Care Needs

1University of Minnesota, Minneapolis, MN 55455, USA
2Children’s Hospitals and Clinics of Minnesota, Minneapolis-Saint Paul, MN 55404, USA
3Children with Special Health Care Needs Program, Washington State Department of Health, Olympia, WA 98504, USA
4Benton-Franklin Health District, Kennewick, WA 98336, USA

Received 28 December 2012; Accepted 22 January 2013

Academic Editors: L.-Y. Chien and A. Green

Copyright © 2013 Karen A. Monsen et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objectives. To evaluate the feasibility of implementing a statewide children with special health care needs (CSHCN) program evaluation, case management, and surveillance system using a standardized instrument and protocol that operationalized the United States Health and Human Services CSHCN National Performance Measures. Methods. Public health nurses in local public health agencies in Washington State jointly developed and implemented the standardized system. The instrument was the Omaha System. Descriptive statistics were used for the analysis of standardized data. Results. From the sample of CSHCN visit reports ( ), 314 problems and 853 interventions were documented. The most common problem identified was growth and development followed by health care supervision, communication with community resources, caretaking/parenting, income, neglect, and abuse. The most common intervention category was surveillance (60%), followed by case management (24%) and teaching, guidance, and counseling (16%). On average, there were 2.7 interventions per problem and 6.7 interventions per visit. Conclusions. This study demonstrates the feasibility of an approach for statewide CSHCN program evaluation, case management, and surveillance system. Knowledge, behavior, and status ratings suggest that there are critical unmet needs in the Washington State CSHCN population for six major problems.