The Quest for New Innovative Care Delivery Models

Kimball, Bobbi; Joynt, Jennifer; Cherner, David; O’Neil, Edward

doi:10.1097/01.nna.0000285142.57118.56

Cited by 38 publications

(26 citation statements)

References 7 publications

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“…This was assessed with qualitative data collected from nurses and managers at the unit level, using five indicators derived from a large American study [31]. These indicators define five main features of innovative nursing care delivery models: elevated RN role; sharpened focus of care on the patient; mechanisms to ensure smooth patient transitions across care settings and links with communities; mechanisms for monitoring results to improve performance; and leveraging of technologies to optimize work processes.…”

Section: Methodsmentioning

confidence: 99%

“…A vast empirical study by the Robert Wood Johnson Foundation involving in-depth examinations of 24 care delivery models has revealed that innovative practice environments are an essential feature of many emerging nursing care delivery models. Innovative practice environments are defined as those in which nurses at the unit level are empowered and have access to the levers needed to carry out new roles, smooth patient transitions, foster patient involvement in nursing care and monitor the impact of their work on quality, safety and cost [31]. In addition to those aspects that generally define magnet hospitals, examining innovative capacity at the unit level makes it possible to take into account a broader set of factors, such as effective leveraging of nurses’ role, technology, linkage with the community, results management and feedback, and patients’ centrality in care.…”

Section: A Conceptual Framework For Developing a Taxonomy Of Nursing mentioning

confidence: 99%

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A taxonomy of nursing care organization models in hospitals

Dubois

D’Amour

Tchouaket

et al. 2012

BMC Health Serv Res

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BackgroundOver the last decades, converging forces in hospital care, including cost-containment policies, rising healthcare demands and nursing shortages, have driven the search for new operational models of nursing care delivery that maximize the use of available nursing resources while ensuring safe, high-quality care. Little is known, however, about the distinctive features of these emergent nursing care models. This article contributes to filling this gap by presenting a theoretically and empirically grounded taxonomy of nursing care organization models in the context of acute care units in Quebec and comparing their distinctive features.MethodsThis study was based on a survey of 22 medical units in 11 acute care facilities in Quebec. Data collection methods included questionnaire, interviews, focus groups and administrative data census. The analytical procedures consisted of first generating unit profiles based on qualitative and quantitative data collected at the unit level, then applying hierarchical cluster analysis to the units’ profile data.ResultsThe study identified four models of nursing care organization: two professional models that draw mainly on registered nurses as professionals to deliver nursing services and reflect stronger support to nurses’ professional practice, and two functional models that draw more significantly on licensed practical nurses (LPNs) and assistive staff (orderlies) to deliver nursing services and are characterized by registered nurses’ perceptions that the practice environment is less supportive of their professional work.ConclusionsThis study showed that medical units in acute care hospitals exhibit diverse staff mixes, patterns of skill use, work environment design, and support for innovation. The four models reflect not only distinct approaches to dealing with the numerous constraints in the nursing care environment, but also different degrees of approximations to an “ideal” nursing professional practice model described by some leaders in the contemporary nursing literature. While the two professional models appear closer to this ideal, the two functional models are farther removed.

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Section: Methodsmentioning

confidence: 99%

Section: A Conceptual Framework For Developing a Taxonomy Of Nursing mentioning

confidence: 99%

A taxonomy of nursing care organization models in hospitals

Dubois

D’Amour

Tchouaket

et al. 2012

BMC Health Serv Res

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“…At Baptist Hospital in Miami, expert nurses serve as patient care facilitators (PCFs). 21 The PCFs direct and manage care for a group of patients, mentor practice development, and are the key contact for physicians. Similar models have been implemented at Seton Family of hospitals in Austin and High Point Regional Health System in High Point, North Carolina.…”

Section: Potential Strategiesmentioning

confidence: 99%

Supporting the Learning Curve for Contemporary Nursing Practice

Burritt

Steckel

2009

JONA: The Journal of Nursing Administration

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Contemporary patient care demands expert nurses with advanced clinical judgment and reasoning abilities. Expertise develops for an extended experiential learning process of 5 years or more and cannot be accomplished through educational preparation alone. Current approaches to orientations, residencies, and care delivery do not support the learning curve to expert practice. The authors outline strategies for change in the practice setting to facilitate expertise development and safeguard patients while learning occurs.

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“…This is particularly so in aged care, where the shortage of nursing professionals is heavily felt amongst a client population with multiple, complex, comorbidities and increasing frailty (Australian C N C N C N C N workplace practice model; workforce staffi ng model; staffi ng model; nursing staff mix model; and model of care/care model/nursing care delivery system (Department of Health and Ageing, 2005;Kimball, Joynt, Cherner, & O'Neil, 2007;McGillis-Hall, 2003;McGillis-Hall & Doran, 2003;Wolf & Greenhouse, 2007). The terms 'models of care' and 'staffi ng models' are often used interchangeably and are rarely clearly defi ned within the literature, while 'workplace practice'; 'staffi ng models' and 'models of care' are very closely related and enmeshed with each other.…”

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confidence: 99%

Beyond ‘doing’: Supporting clinical leadership and nursing practice in aged care through innovative models of care

Venturato

Drew²

2010

Contemporary Nurse

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Contemporary health care environments are increasingly challenged by issues associated with the recruitment and retention of qualified nursing staff. This challenge is particularly felt by residential aged care providers, with registered nurse (RN) numbers already limited and resident acuity rapidly rising. As a result, aged care service providers are increasingly exploring creative and alternative models of care. This article details exploratory research into a pre-existing, alternative model of care in a medium sized, regional residential aged care facility. Research findings suggest that the model of care is complex and multi-faceted and is an example of an integrated model of care. As a result of the implementation of this model of care a number of shifts have occurred in the practice experiences and clinical culture within this facility. Results suggest that the main benefits of this model are: (1) increased opportunities for RNs to engage in clinical leadership and proactive care management; (2) improved management and communication in relation to work processes and practices; and (3) enhanced recruitment and retention of both RNs and care workers.

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The Quest for New Innovative Care Delivery Models

Cited by 38 publications

References 7 publications

A taxonomy of nursing care organization models in hospitals

A taxonomy of nursing care organization models in hospitals

Supporting the Learning Curve for Contemporary Nursing Practice

Beyond ‘doing’: Supporting clinical leadership and nursing practice in aged care through innovative models of care

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