In response to growing nurse shortages and heightened attention to patient quality, many healthcare organizational leaders are developing and testing new care delivery models. These models strive to improve patient quality and satisfaction by engaging nurses and other healthcare professionals in different roles across the continuum of care. In this article, the authors profile 5 new care delivery models from their current work sponsored by the Robert Wood Johnson Foundation. In addition, the authors identify common elements underlying the success of the models.
Nursing workforce has become a priority for health care leaders, policy makers and the nursing profession. The confluence of demography, a changing health care system, social values, and work climate has created the overwhelming nature of today’s nursing crisis. These drivers represent a complexity that render past responses inadequate and serve to shape new ways in which health providers, education, government, labor, and professional groups must respond. Activities underway at the national, state, and institutional levels by various sectors range from short-term fixes to long-term interventions, which address structural issues that underlie the current shortage. Actions being taken are sequenced into four stages along a continuum, exploring the evolutionary roles of professionalism, interdependency, technology, diversity, leadership, and consumer need. Each stage represents a step toward nursing’s movement from a work force commodity to a vital strategic asset, necessary to ensure the long-term viability and success of any health care institution or system.
Implementation of innovative patient care delivery models provides an opportunity to examine how effective nurse leaders are leading change in the healthcare system. The trends and pressures that make change imperative, not optional, are discussed in other articles in this issue. The focus of this article is on how chief nursing officers improve patient safety and increase care quality while managing the complexities of the nursing workforce and controlling costs. The authors examine the leader's role in the change process, in particular, the role of nursing leaders. The care delivery model is considered an instrument for change, and the chief nursing officer is a change agent.
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