Professional Documents
Culture Documents
Organizing Patient Care
Organizing Patient Care
Fall 2010
Learning Objectives
• differentiate among various types of patient
care delivery systems
• discuss the relationship between managed
care and case management
• list the essential components of total patient
care, team nursing, primary nursing, and case
management
• discuss how work redesign may affect social
relationships on a unit
• explain what effect staff mix has on work
design and the patient care organization
Fall 2010
• What is our focus……
• Why are we here…….
• ….patients now more than ever
need reassurance that they are
indeed the focus of the healthcare
team - Joan Shinkus Clark
Fall 2010
Traditional Modes of Care Delivery
• Total Patient Care
• Functional Nursing
• Team and Modular Nursing
• Primary Nursing
• Case Management
Fall 2010
Disease Management
• Common high-cost, high-resource utilization
diseases
• Population-based health care
– Covered lives
• Continuous health improvement
• A population with a costly disease, people who are
on outpt dialysis. Focus is on the population. We
want to provide optimal, cost effective care. By
doing this we can actually do a lot of prevention
(hopefully). Going to diabetic clinic and teaching
them so we can hopefully prevent them from
reaching the need for outpt dialysis.
Differentiated Nursing Practice
• Education Model (Type 1)
– Based on type of education
– They’ve been trying to do this for a long time
• Competency Model (Type 2)
– Based on individual skill level
• Benner’s Novice to Expert (goes along with
competency model)
– Novice
– Advanced beginner
– Competent nurse
– Proficient nurse
– 2010
Fall Expert
Differentiated Nursing Practice Cont.
• To match the pt’s needs with nursing competence,
and have the most efficient use of nursing
resources.
• Education based thing really irritates Ponder. She
thinks RN’s who pass boards are RN’s who pass
boards.
• Competency she agrees with. Placing SICU nursing
in SICU, not taking a newborn nurse and putting
them in SICU. That’s not fair to the SICU pt.
• Match the pt’s needs with the abilities of the nurse
The Future
• Nursing shortages and health care reform have had
a strong impact on the creation of new and
evolving types of patient care delivery models.
– We’re seeing pt focus teams. By that she means the
teams have nurses, PT, OT, Dietary, any body else that
you can possibly thing of. Everyone gets an input, and
you have all the teams working together.
The challenges
• Cost containment
• Demand for quality outcomes
• Information age
• Patient population
• Multigenerational workforce
Fall 2010
The Optimum Mode of Care
• Carefully constructed
• Not based solely on economics
Fall 2010
Integrating Leadership Roles
• No one best mode
• Accomplishment of unit goals
• Seeking solutions not finding fault
– Working together
• Facilitates innovative thinking
• Ensures adequate resources
• Reduce resistance
• Remember, change is inevitable
Fall 2010
Summary
• Nursing leaders and managers have the responsibility to
facilitate the design of care delivery models
• Nurses deliver and coordinate patient care
• The challenges for patient care in the future are massive
• The work environment of the nurse is dramatically different
from any other time
• Discover innovative ways to organize and deliver care
Fall 2010