Vol. 12/No. 2 Professional Case Management 93 Professional Case Management Vol. 12, No. 2, 93–105 Copyright © 2007 Wolters Kluwer Health | Lippincott Williams & Wilkins National Breast and Cervical Cancer Early Detection Program (NBCCEDP). The WHN CVD risk compo- nent is funded solely by the CDC through the Well- Integrated Screening and Evaluation for Women Across the Nation (WISEWOMAN) program. The Massachusetts Department of Public Health (DPH) ad- ministers the WHN and contracts with healthcare orga- nizations—referred to as contracting organizations—to T he purpose of this study was to examine the work of nurse case managers in the Women’s Health Network (WHN), a Massachusetts Department of Public Health—sponsored breast and cervical cancer and cardiovascular disease (CVD) risk screening program. The study is part of a larger project designed to evaluate case management prac- tices at 26 WHN healthcare organizations through- out Massachusetts (Schutt et al., 2005). The WHN provides free screening examinations to women for early detection of breast and cervical cancer and CVD. WHN-eligible women must have an income of no more than 250% of the federal poverty level and be uninsured or underinsured. The WHN breast and cervical cancer program component is funded by the Commonwealth of Massachusetts and the U.S. Centers for Disease Control and Prevention (CDC), through the The Work of Nurse Case Managers in a Cancer and Cardiovascular Disease Risk Screening Program Jacqueline Fawcett, PhD, RN, FAAN, Russell K. Schutt, PhD, Gail B. Gall, MS, APRN, BC, Elizabeth Riley Cruz, MA, and Mary Lou Woodford, BSN, RN, MBA, CCM The authors thank Maria Rocha-Tracy for her assistance with data entry. The study was funded by a contract from the Massachusetts Department of Public Health. Address correspondence to Jacqueline Fawcett, PhD, RN, FAAN, PO Box 1156, 3506 Atlantic Highway, Waldoboro, ME 04572 (jacqueline.fawcett@umb.edu). ABSTRACT Purpose of the Study. The purpose of this conceptual model of nursing and health policy—based study was to identify the frequency and correlates of activities performed by nurse case managers. Primary Practice Settings. Massachusetts Women’s Health Network (WHN) contracting organization sites for breast and cervical cancer and cardiovascular disease risk screening. Methodology and Sample. Twenty nurse case managers were interviewed. Results. More time was spent performing client service activities than bureaucratic activities. Frequently performed client service activities were tracking test results, finding/connecting with clients, assessing client needs, and educating clients. The most frequently performed activity was documenting services; the least, discharging clients. Client service activity frequency was correlated with client caseload size, social barriers, overall workload, satisfaction with the way activities are carried out in the WHN, special training in WHN policies and procedures, and contracting organization service delivery arrangements. Bureaucratic activity frequency was correlated with caseload size, workload, months as a WHN case manager, system barriers, satisfaction with the way activities were carried out in the WHN, and special training. Implications for Case Management Practice. • Documentation requires a great deal of WHN nurse case managers’ time, which perhaps could be more productively spent with clients. Thus, more efficient ways to document services need to be identified. • Additional research is needed to determine similarities and differences in activities performed by WHN nurse case managers and other case managers working in cancer and cardiovascular disease screening programs. • Strategies need to be identified to remove all barriers that interfere with performance of case manager practice activities. • Strategies are needed to reduce client fear of bills, overcome scheduling constraints, and improve translation services to lessen language barriers to effective communication. PCM_93-105 3/14/07 6:48 PM Page 93