I read with interest "The Clinical Nurse Leader and the Case Manager: Are Both Roles Needed?" (January).

I was surprised and disappointed that the authors and AJN didn't incorporate the definition and description of nursing case management provided by the American Nurses Credentialing Center (ANCC).1 With the assistance of the ANCC, the authors might have gained a better appreciation for the variety of safety and quality outcomes on which nurse case managers focus.

Zara R. Brenner, MS, RN-BC, ACNS-BC

Rochester, NY

Authors Mary Elizabeth Stachowiak and Mary Jo Bugel respond: The ANCC definition of a case manager (CM) is substantively the same as the one we used from the Case Management Society of America.

We agree that a CM has many opportunities to impact quality and safety outcomes. Compliance with the best practice initiatives of the Joint Commission is an example of such an opportunity (for more information, visit http://bit.ly/SiprLr). The CM might be responsible for identifying patients who meet certain criteria and for implementing or delegating the completion of the initiatives. By contrast, a clinical nurse leader (CNL) might evaluate the microsystem for process issues, to maximize compliance and implement a change in practice to improve compliance.

We have great respect for the CM role and feel strongly that both it and the CNL role are crucial and necessary to quality patient care.

For more letters from AJN readers, go to http://links.lww.com/AJN/A47.

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