Health Care Delivery Models
March 10, 2015
The primary goal of all health care facilities is to provide safe, quality cost-effective to all patients. This is best accomplished when the number of staff members are closely matched to the number of patients. According to Cherry and Jacobs (2014), patient care delivery systems detail the way task assignments, responsibility, and authority are structured to accomplish patient care. Through different delivery systems different health care areas are able to perform safe, quality, cost-effective care to all patients. Such delivery systems include team nursing, primary nursing, functional nursing, total care nursing, and case management nursing. These delivery systems will be described in the following text along with which system is used at Mizell Memorial Hospital and the role of the case manager at Mizell Memorial Hospital. “Team nursing is where a registered nurse (RN) functions as a team leader and coordinates a small group (generally no more than four or five people) of ancillary personnel to provide care to a small group of patients” (Cherry & Jacobs, 2014). According to Cherry & Jacobs (2014), the RN must know the condition and needs for all patients and plan for individualized care for each patient assigned to their team. The RN is also responsible for encouraging a professional working environment and maintaining clear communication among all team members. “the team leader’s duties include assessing patients and planning care, assigning duties, directing and assisting team members, giving direct patient care, teaching, and coordinating patient activities” (Cherry & Jacobs, 2014). Team nursing has been used in many inpatient and outpatient health care facilities and is an efficient method of patient care delivery. In order for team nursing to be an effective health care delivery model the RN must have strong clinical skills, delegating abilities, and an ability to maintain a professional working environment. “In primary nursing, the RN, or “primary” nurse, assumes 24-hour responsibility for planning, directing, and evaluating the patients care from admission through discharge” (Cherry & Jacobs, 2014). With this health care delivery model the RN, while on duty, may provide total care or delegate some patient care task to the licensed practical nurse (LPN) and unlicensed assistive personnel (UAP). According to Cherry & Jacobs (2014), when the primary nurse/RN is off duty patient care is provided by an associate nurse who follows the care plan established by the RN. Should any problem, complication, or change in the patient’s plan of care arise while the RN (who has a 24-hour responsibility) is off duty, the nurse in charge must report those changes to the primary nurse. The RN using the primary nursing model of care must be able to maintain clear communication with all team members to include: the patient, patient’s family, associate nurse, physician, and all other health care team members. The primary nursing health care delivery model is best used in long term care settings where patients require care for an extended period of time such as hospice and home health nursing. “In the functional nursing health care delivery model staff members are assigned to complete certain task for a group of patients” (Cherry & Jacobs, 2014). According to Cherry & Jacobs” (2014), an example of functional nursing would be when the RN performs all assessments and care planning, and administers all intravenous medications; the LPN gives all oral medications; and the UAP performs all hygiene task and takes vital signs. The charge nurse who is usually the RN makes the assignment for staff members and coordinates all patient care. “Although the functional nursing model is considered efficient and economical, the patient is treated by many caregivers who are not able to provide personalized care because they focus on performing a task...
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