Health Care Delivery Models and Nursing Practice

Health care delivery models are methods that guide the assignment of nursing responsibilities, authority, and patient care management. These models are tailored to meet the diverse needs of patient populations, ensuring efficient, high-quality care while maximizing the utilization of available nursing resources and skills. In this blog post, we will explore some of the common and emerging health care delivery models and how they affect nursing practice.

Total Patient Care

Total patient care is a traditional model in which the registered nurse (RN) assumes responsibility for a group of patients for the duration of a shift and provides all care to this group of patients. This model provides continuity for the shift and ensures clear responsibilities. For nurses, it is generally a satisfying system of providing care. However, total patient care can be very expensive while not utilizing RN’s time wisely. Especially with staffing shortages, following this model may not be possible.

Primary Nursing

Primary nursing is a model in which RNs assume 24/7 accountability for their primary patients, establish a plan of care, and coordinate that care plan even in their absence. This model ensures excellent holistic care for patients and leads to high job satisfaction of nurses. However, primary nursing is difficult to implement in today’s flexible scheduling, and requires a high RN mix. Additionally, some staff do not want to accept the accountability and responsibility that comes with the primary nursing care delivery model.

Functional Nursing

Functional nursing is a model in which each member of the nursing team performs specific tasks for a large number of patients. For example, one nurse may administer medications, another may perform treatments, and another may document care. This model allows for efficient use of resources and skills, but it can compromise continuity and quality of care. Patients may feel neglected or confused by multiple caregivers, and communication and coordination among staff may be challenging.

Team Nursing/Modular Nursing

Team nursing or modular nursing is a model in which a team of nurses and other health care professionals provide care to a group of patients under the supervision of a team leader. The team leader assigns tasks based on the needs and abilities of each team member. This model promotes collaboration and delegation, but it also requires effective communication and leadership skills. The quality and continuity of care may vary depending on the team composition and dynamics.

Case Management

Case management is a model in which a case manager coordinates the care of a specific group of patients across the continuum of care. The case manager collaborates with other health care providers to ensure that the patient receives appropriate, timely, and cost-effective services. The case manager also monitors the patient’s progress and outcomes, and adjusts the plan of care as needed. This model improves patient satisfaction and quality of care, but it also requires extensive knowledge and skills in assessment, planning, evaluation, and communication.

Conclusion

Health care delivery models are constantly evolving to meet the changing needs and expectations of patients, providers, and payers. Nurses play a vital role in these models as they provide direct patient care, coordinate care across settings, and integrate care across disciplines. Nurses need to be aware of the strengths and weaknesses of each model, as well as their own roles and responsibilities within them. By doing so, nurses can ensure that they deliver safe, effective, and patient-centered care.

References

– Lecturio (2023). Nursing Care Delivery Models [+ Free Cheat Sheet]. Retrieved from https://www.lecturio.com/nursing/free-cheat-sheet/nursing-care-delivery-models/
– Columbia School of Nursing write my thesis (2022). Models of Health Care Delivery. Retrieved from https://www.nursing.columbia.edu/research/research-areas-focus/models-health-care-delivery
– AMN Healthcare (2021). New Healthcare Delivery Models Are Redefining the Role of Nurses. Retrieved from https://www.amnhealthcare.com/blog/nursing/travel/new-healthcare-delivery-models-are-redefining-the-role-of-nurses/

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