Match the patient care delivery model with its description.

A Nursing Care Delivery System defines the way we use our nursing values to care for our patients, families, colleagues, and selves.

The care delivery system is actually a subsystem of the professional practice model that describes our approach to delivering patient care by:

1. Detailing assignments, responsibilities and authority to accomplish patient care;
2. Determining who is going to perform what tasks, who is responsible, and who makes decisions; and
3. Matching number and type of caregivers to patient care needs.

Relationship Based Care

Guided by our PPM, MUSC Nurses adopted Relationship Based Care (RBC) as our nursing care delivery system. 

In RBC, the patient and family are always the central focus with an emphasis on the development of collaborative relationships needed to provide excellent patient care. There are three crucial relationships in RBC: 

• Relationship with patients and their families. Care givers demonstrate unwavering respect for the patient and family and actively engage them in all aspects of care.
• Relationship with colleagues. Care givers are committed to a common purpose and respect each colleagues’ unique contribution to the team.
• Relationship with self. Care givers balance the demands of their role with their personal and professional health and well-being.

RBC is built on the tenet that the Registered Nurse has the authority, responsibility and accountability for the nursing process. How the RBC framework is implemented varies by setting but always reflects the PPM and core principles. The building blocks of the care delivery system in all settings include the following.

Nurse-Patient Relationship & Decision Making

• RNs develop therapeutic caring relationships with patients and families/care givers.
• The scope/duration of the nurse-patient relationship is defined by the needs of the patient and the care environment.
• Decisions about care are made collaboratively with the patient or their representative based on the patient’s values, beliefs, and needs.
• Nurses serve as patient advocates when the patient is not able or available to speak for themselves.

Work Allocation and/or Patient Assignments

• RNs are involved in the planning and implementation of staffing plans that meet the needs of the patient/family.
• Patient/nursing care assignments are based on the care environment, the needs of the patient and family, and staff competency.
• While supporting continuity of care, work allocations and/or assignments may vary based on changing needs.

Communication Between Health Care Team Members

• RNs actively participate in established processes for planning and evaluating interdisciplinary care.
• RNs communicate directly with other members of the healthcare team, taking an active role in coordinating the patient’s care.
• Formal and informal leaders serve as a resource to nursing staff and support the role of the RN in the coordination of patient care.

Management of the Unit or Environment of Care

• Nursing staff are accountable for recognizing issues in the environment of care and actively working to resolve them.
• Managers are accountable for seeking nursing staff input in decisions that impact the environment of care.
• Formal and informal leaders serve as a resource to nursing staff and support the role of the RN in the coordination of patient care.

Clinical pathway:

Clinical management plans that specify the optimal timing and sequencing of major patient care activities and interventions by the interprofessional team for a particular diagnosis, procedure, or health condition and are designed to standardize care delivery (Coffey et al, 2005); clinical pathways may also be called critical paths, practice protocols, or care maps; clinical pathways support the implementation of clinical practice guidelines.

Clinical practice guidelines:

Recommendations for appropriate treatment and care for specific clinical circumstances; guidelines are developed though a systematic process to integrate the best evidence for treating specific medical conditions and assist health care providers to make decisions about appropriate treatment (Institute of Medicine [IOM], 1990).

Nursing care delivery model:

Also called care delivery system or patient care delivery model; details the way work assignments, responsibility, and authority are structured to accomplish patient care; depicts which health care worker is going to perform what tasks, who is responsible, and who has the authority to make decisions.

Patient acuity:

Indication of the amount and complexity of care required for any particular patient; high acuity indicates a need for more intense, complex nursing care as compared with lower acuity, which indicates a need for moderate, less complex nursing care.

Patient classification system:

Method used to group or categorize patients according to specific criteria and care requirements and thus help quantify the patient acuity, or amount and level of nursing care needed.

Staff mix:

Combination of categories of workers employed to provide patient care (e.g., RNs, LPNs, or licensed vocational nurses [LVNs], or unlicensed assistive personnel [UAP]).

Staffing:

Ensuring that an adequate number and mix of health care team members (e.g., RNs, LPNs or LVNs, UAP, clerical support) are available to provide safe, quality patient care; usually a primary responsibility of the nurse manager.

Unlicensed assistive personnel (UAP):

An unlicensed individual who is trained to function in an assistive role to the RN by performing patient care activities as delegated by the nurse; may include nursing assistants, clinical assistants, orderlies, health aides, or other titles designated within the work setting.

What are models of patient care delivery?

What are the types of patient care models?

Which is the best definition of a nursing care delivery model?

Which nursing care delivery model does the nurse use when providing care for the same client for the entire work period?