Care delivery models: Challenge to change

Abstract

Aim The purpose of this project was to evaluate a partnership model of care delivery on nurse and patient satisfaction and clinical outcomes. Background Care delivery models result in practical staff assignment decisions based on perceived fairness. The division of labour lies in social interaction of participants. Research notes that partnership team models require effective communication skills and delegation abilities to sustain. Method This project used multiple methods in two study sites. A convenience sample was used to assess measures. Institutional Review Board approval obtained. Results Nurse satisfaction statistically increased in one setting and statistically decreased in the other setting. One statistically significant difference in a clinical outcome was noted. Patient satisfaction, nurse turnover and vacancy rates failed to reveal anything of statistical significance. Observed operational care components improved in both settings. Conclusions Care delivery models are determined by a variety of factors of resource availability, unit culture, and quality and patient safety priorities. Identification of preferential structural approaches to guide nursing workflow is needed. Implications for Nursing Management Innovative models of care delivery must be predicated on new role skills of delegation and negotiation for nurses, purposeful oversight and mentoring for sustainable success. Staffing can influence the integrity of care delivery models.

An Integrative Review of Team Nursing and Delegation: Implications for Nurse Staffing during COVID‐19

“…Fernandez et al, ( 2012 ) reported that the evidence surrounding team nursing had inconsistent findings on falls and medication errors compared with other care models. On the contrary, several studies reported negative outcomes with team nursing such as increased adverse events compared with the patient allocation model (Havaei, MacPhee, & Dahinten, 2019 ), decreased mobility compared with a modified primary nursing model (Winslow et al, 2019 ), and decreased quality of care compared with primary nursing (Betz, Dickerson, & Wyatt, 1980 ).…”

“…Findings across these studies were inconsistent. Three studies reported an improvement in job satisfaction (Dickerson & Latina, 2017 ; Downs & Hoil, 2004 ; Murphy, Pearlman, Rea, & Papzian‐Boyce, 1994 ); three studies reported a reduction (Hayman, Wilkes, & Cioffi, 2008 ; Mäkinen, Kivimäki, Elovainio, Virtanen, & Bond, 2003 ; Ryan, Poster, Auger, Davis, & Ringdahl, 1988 ); and three studies reported no difference (Carlsen & Malley, 1981 ; King, Long, & Lisy, 2015 ; Winslow et al, 2019 ). The systematic review by Fernandez et al, ( 2012 ) also found conflicting evidence about RN satisfaction.…”

“…Additional important outcomes when comparing team nursing to other models of care included RN attrition and turnover, absenteeism, staff communication, stress, and role clarity. Numerous studies found no difference in attrition and turnover when comparing team nursing to the patient allocation model (Hayman et al, 2008 ; King et al, 2015 ); modified team nursing model (Dobson et al, 2007 ); or a primary nursing model (Winslow et al, 2019 ). The reports on absenteeism included three articles that found no difference (Butler et al, 2019 ; Fernandez et al, 2012 ; Hayman et al, 2008 ) and one article that found a reduction compared with primary nursing (Murphy et al, 1994 ).…”

Exploring hospital compliance with the primary nursing care model: validating an inventory using the Delphi method

“…To facilitate the development, implementation, and evaluation of an NCDM, focusing on the role of nursing [ 16 ] in terms of development strategies [ 17 ] and system evaluation control is crucial [ 18 ].…”

Nursing care delivery models and outcomes: A literature review

“…11,23 One paper examined a Comprehensive Care Model of Nursing Care delivery in Korea. 24 The three remaining papers examined the introduction of a Modified TPC Model, 25 the introduction of a Partnership Care Delivery Model, 26 and another examined a collaborative model of care with RNs and LPNs. 27 The third systematic review examined usual care provided in a medical-surgical unit for geriatric clients when compared with a Geriatrics Unit ACE model of care.…”