Coordination of care

Nursing case management does not require a physician prescription. It's time to sit down with these docs -- they must have a staff meeting once a month, or the like-- and explain that you -- YOU -- would like to help them coordinate care so it can be delivered more efficiently and with better patient satisfaction. You might want to get your ducks in a row ahead of time by involving anesthesia, lab, radiology, pharmacy, risk management, billing, and anyone else with a useful opinion who might be affected by this accident-waiting-to-happen. If they can't attend the meeting, have them write up little somethings for you to distribute.

Yes, you can do this. Involve your nursing manager to get his/her blessing and/or the blessing of the nursing department. it makes such good sense, I'll bet they'll let you give it a shot. Don't be afraid to ask for help.

Since you are in a hospital, it is likely that your patients are covered by some form of insurance. That entitles them to case management regardless of physician preference, because it is in the carrier's interest to keep things efficient. Call them up and ask to speak to the head of nursing case mgmt, and see if s/he can help you, too.

I agree with getting your manager involved. If you frame the problem as something that is beneficial to the patients, and you have a recommendation or two, then why not? Maybe your manager has the power to change the rules of using the case manager.