A cardiovascular intensive care nursing staff response to managed care: a change in practice.

Managed care has brought competition to the health care workplace. This competitive atmosphere creates challenges to attain quality outcomes while minimizing costs. A large community hospital in the mid-Atlantic region, in a collaborative effort with all members of the health care team, undertook the challenge to revise the way care was delivered to the cardiac surgical patient. This article will report the changes the cardiovascular intensive care nursing staff had to undergo and the methods that were used to incorporate these changes.