Nursing Care Delivery Model – Is There a Better Way?

By Angela Wale, system director, nursing professional practice and research

At Premier Health, our professional practice model – which guides the way we care for patients and families – is founded on Relationship-Based Care (RBC). The RBC model describes six key roles of a nurse. One of those roles is that of a leader. As Magnet®-designated nurses, we have a responsibility to “identify and initiate changes that will improve the quality of care for patients and families.” It is this professional responsibility that urges us to evaluate the structure we have in place for nursing care delivery.

While nurse leaders across Premier Health work diligently to fill our vacancies with additional registered nurses (RNs), including nearly 300 new graduate nurses since January 2019, data shows that the nursing shortage we are experiencing in our community is a national concern. We must discover ways to become more effective by ensuring that RNs’ time is spent within the scope of nursing. This has been challenging with our current RN-PCT care delivery model.

A group of expert clinical nurses and nurse leaders have come together to study best practices and use creativity and innovation to determine if there is a better way. This team has been asked to consider a care delivery model that will pull additional support around RNs in the acute care environment. This will allow RNs to more consistently practice nursing at the top of license to coordinate delivery of care to our patients while providing oversight to validate that care is occurring as intended.

Recently, we have been observing the work of clinical nurses who provide direct care to patients. These observations are allowing us to identify the type of work that RNs can delegate in some care settings. As nurse leaders, we recognize that this will be a process of transition for us. We will need to experiment with models that might not work to learn and adapt to models that do work. Our goal by the end of this year is to pilot a new care delivery model on at least one inpatient nursing unit. And our hope is that Premier Health nurses can pave the way for our colleagues across the nation who are facing similar health care challenges and nursing shortages.

Back to the August 2019 issue of the Nursing Newsletter