The Role of Head Nurses in Developing an Intermediate Care Network System From Hospital to Community: A Descriptive Qualitative Study

Abstract

This qualitative study aimed to investigate the role of head nurses in developing an intermediate care network system from hospital to community, examine its associated outcomes, and synthesize the key conditional factors underlying successful network development. Thirty-one informants were purposively selected, comprising one head nurse, five ward heads involved in intermediate care, five case manager nurses, and 20 network partner representatives. The study was conducted from April to December 2025, with data collected through in-depth interviews, observations, and document reviews. Data were analyzed using content analysis, and the trustworthiness of the findings was established through data and methodological triangulation.

Four principal themes emerged: (1) the context and pathway toward head nurse role development, in which gaps within the existing system and the absence of connectivity between hospital and community served as key drivers for network development; (2) head nurse roles, including shared vision building, visionary leadership, strategic management, team capacity development, resource management, and network coordination; (3) the resulting outcomes, with informants reflecting on greater continuity of care, more comprehensive patient follow-up, strengthened and more trusted network relationships, as well as increased knowledge and confidence among personnel in the care of intermediate care patients; and (4) conditions underlying success, including visionary and practice-oriented leadership, administrative support, inter-organizational relational capital, and a culture of shared learning and mutual adaptation. The findings illuminate pathways for developing head nurses' roles in linking intermediate care systems between hospitals and communities, fostering continuity and sustainability.