Clinical Nurse Specialists

Leaders in Managing Patients With Chronic Conditions

Mary P. Hansen; Mitzi M. Saunders; Cynthia R. Kollauf; Ludmila Santiago-Rotchford


Nurs Econ. 2019;37(2):103-109. 

In This Article

Abstract and Introduction


The complex care of patients with chronic conditions threatens the stability of healthcare economics. Clinical nurse specialists, in roles that leverage full scope of practice, positively impact the Triple Aim and are vital to meeting this rising need.


We live in an era where over 50% of health care is devoted to attention around chronic conditions (Ward, Schiller, & Goodman, 2014), which account for 7 of the top 10 causes of deaths and contribute to 74% of all deaths in the United States (Murphy, Xu, Kochanek, & Arias, 2018). With the tsunami of older adults expected to reach 98 million by 2060 (U.S. Department of Health and Human Services [HHS], 2016), the provision of care for persons with chronic conditions poses increasing economic burdens. Care of this population accounts for 86% of U.S. healthcare costs (Gerteis et al., 2014) and becomes even more inordinate in individuals with multiple chronic conditions and complex social determinants of care (Craig, Eby, & Whittington, 2011). The National Association of Clinical Nurse Specialists (NACNS) sensed this urgency and appointed a taskforce to demonstrate clinical nurse specialists (CNSs) as leaders in the care of patients with chronic conditions (NACNS Chronic Conditions Task Force, 2017). This article includes information from the work of taskforce members as well as additional evidence that CNSs are uniquely prepared to lead and manage populations of patients with chronic conditions and positively affect health care and nursing economics.