As expected, journal articles formed the base of the core literature of case management, accounting for nearly two-thirds of all cited references. Books and other monographs were also important. The fact that the reports category accounted for a significant number (6.3%) of cited references should interest librarians, because copies of these documents can be especially challenging to locate. While Internet documents were cited infrequently, the Web might also be a source for locating the reports of various professional organizations and advocacy groups.
The field of case management has been developing rapidly, with its significance increasing over the past two decades. Secondary sources such as books and monographs constituted a significant portion of the cited literature, especially for articles discussing the process of case management. More than 67% of the books from the 1990s were published prior to 1997, while 26% of the total books were published in the 1980s (). Because 33% of the source articles were published in 1997, a certain percentage of citations would be expected to be from the early 1990s. But a seemingly heavy reliance on older literature might also indicate authors' use of monographs that were readily available and with which they were familiar.
Other nontraditional formats, such as government documents and the reports of professional organizations and advocacy or advisory groups were also important components of the core literature. Although more than 86% of the government documents were from the 1990s, more than 50% of those were published in the early portion of the decade. Again, this reliance on older literature might be the result of using what was convenient. Access to and knowledge of the plethora of government statistics, guidelines, and other documents via the Internet should improve the currency of the reference literature.
Current statistics and disease information were frequently derived from associations' or nonprofit organizations' publications and Websites, listed under reports. The reports were more current than other categories. Citing recent conferences and drug inserts might also slant the miscellaneous category toward currency. As knowledge of, and comfort with, accessing quality information via the Internet improves, it will be interesting to track the number of future citations in the Internet category. Will there be increased reliance on general Websites and online communication or will the online version of traditional reports be cited? If the latter occurs, will it impact the currency of those citations?
The diversity of cited journals reflects the dual focus of nursing case management—managing the patient while also managing the process of patient care. Judging from the source articles and the titles of the cited journals, the literature of case management can be divided into two broad categories: literature related to the process of case management and the health care system and “clinical” literature. One possible explanation for the emphasis on process is that case management practice is relatively new and needs to be defined along with its role in both the health care and educational systems. Many case managers have learned case management from peers, have heavy caseloads, and frequently work independently [21
]. Journals permit nurse case managers to remain current on contract theory, delivery models, case maps, discharge planning, communication, legislation, and economics. shows the subjects represented by journals in Zone 1: case management (3 titles), nursing administration (3 titles), and social work (2 titles).
Given this diversity, one challenge for nurse case managers is to determine which databases to select when searching for pertinent articles. As the indexing coverage demonstrated, PubMed provides good coverage, especially when the focus of the search is on the clinical aspects of practice. Given the multidisciplinary nature of case management, one might have expected greater coverage in those databases with a social sciences focus. Indexing scores for “social work” titles generally are higher in these databases. Of the two nursing databases, CINAHL provides better coverage. Most, but not all, of the nursing journals are extensively indexed. OCLC ArticleFirst should not be overlooked; more than 87% of the journals in Zones 1 and 2 are indexed. Although case management titles are generally not indexed, the coverage for social sciences is very strong, thus potentially complementing the coverage in the more clinically focused databases. However, PubMed/MEDLINE remains the database of choice when searching for information related to case management. In addition to its excellent coverage, it is both free of charge and readily available.
The appearance of journals specific to nursing research and advanced practice nursing in Zones 1 and 2 may reflect the shift toward postbaccalaureate preparation for nurse case managers. Theories and instruments are beginning to emerge in case management, and nurse case managers with advanced degrees would be expected to have better knowledge of analyzing and performing research. As a result, it could also be expected that literature reviews would be more thorough and current and that reliance on the older but easily available textbooks should lessen.
The core literature also reflects a growing mandate for nurse case managers to manage complex patient populations, which requires sophisticated knowledge of specialty practice. Many of the articles in the source journals discuss the management of specific patient population specialities, such as gerontology, psychiatry, oncology, or neurology. For instance, articles might discuss the latest treatments and trends in wound care, pain control, infectious diseases, or even multicultural communication styles. While general medical journals appear among the most highly cited journals in Zone 1, specialty journals account for more than half of the journals in Zones 1 and 2. The focus on providing continuing education credit in two of the source journals (JCM and NCM) may encourage nurse case managers to remain current. These articles frequently reference current materials and provide an alternative to those with limited access to, or knowledge of, libraries and bibliographic databases.
As of early 2005, case management is being discussed in a broader range of journals and trade publications than previously noted in the 1997-to-1999 examination, which may indicate the acceptance of and need for this process-and-outcomes model across the disciplines. However, the three core journals identified in this study remain the only core case management journals and thus an essential part of any collection that supports case management practice. While not part of this study, several of the newer case management newsletters appear robust and may be useful to several library collections. Furthermore, it will be interesting to keep track of new journals focused on geographic areas, such as Great Britain, or specific populations, such as the elderly, as these also may become increasingly rigorous and benefit collections supporting case management practice in the future.
A comprehensive journal collection for nurse case managers would include titles specific to case management, journals addressing heath care and nursing administration issues, and key journals in their clinical specialty areas. Librarians have the opportunity to play an important role in educating nurse case managers about current sources of information and access to information via alternative platforms, such as the Internet. In some instances, librarians might participate in the case management team by providing timely access to current information through literature searches and document delivery.