Nurses normally use care delivery models to assess, plan, and undertake patient care within a framework that promotes quality and satisfaction at a reduced cost. However, in the recent past, health human resources shortage, limited budget, and safety and quality issues have resulted in the development of more suitable or redesigning of the existing nursing care delivery models (Havaei et al., 2019a). The organization under consideration uses the Total-Patient-Care Model for nursing care delivery. The framework is one of the oldest systems and it involves having one nurse organize, plan, and perform all care to a group of patients (Havaei et al., 2019b). A study by Havaei et al. (2019b) illustrates that the Total-Patient-Care model is associated with poor quality delivery of services compared to other programs, such as a team-based system. It also has limited safety outcomes compared to a skill-mix model. Therefore, it is imperative to develop a new system that addressed the drawbacks associated with the Total-Patient-Care model. In this regard, the study aims to suggest a new nursing care delivery model that will reduce costs, and improve quality and safety for the health organization considered.
Proposed Model to Reduce Costs and Improve Quality of Healthcare
The Total-Patient-Care model is associated with reduced quality and safety for the patients. Hastings et al. (2016) suggested that collaborative practice frameworks would improve quality nursing care and patient outcomes. However, it would escalate the cost because of increased human resources. The proposed model will be a team-skill-based system to help improve the quality and safety of nursing care. Therefore, instead of having a single nurse taking care of a group of patients, the framework will allow a team of caregivers to work together. However, to maximize their ability and ensure high quality without duplicating duties, the nurses will work with the right patients in specific wards. Nurses will be assigned to patients based on their expertise and experiences. Besides, the model will operate such that only the required number of nurses are working per shift depending on the number of patients to prevent idling. Overall, the proposed model enhances patient care experience and outcomes by incorporating a team practice and optimizing the skills of the nurses.
The aspect of safety is a crucial consideration in the proposed model. According to World Health Organization, patient safety is defined as the absence of preventable harm to patients and averting unnecessary suffering by healthcare providers (Vaismoradi et al., 2020). Vaismoradi et al. (2020) note that patient harm is one of the top ten causes of death and disabilities. Therefore, it is essential to eliminate patient harm by ensuring safety during nursing care. The proposed model aims to enhance safety by preventing practice errors, which can be achieved by assigning nurses to duties they are experienced at or have considerable expertise in a particular area (Vaismoradi et al., 2020). The model also aims to prevent patient harm by assigning nurses to the recommended number of patients per shift. Fatigue is one of the main causes of patient harm because of loss of focus. Overall, the model promotes safety by assigning nurses to the right number of patients per shift based on their expertise and experience.
Key Concepts of the Suggested Model
The suggested model aims to improve the safety and quality of health care delivery services, and also reduce the cost. It aims to eliminate the concerns associated with the Total-Patient-Care framework. Therefore, it involves a collaborative practice that maximizes the experience and expertise of the nurses. In this regard, the program can be referred to as the Team-Skill-Based Nursing Care Model. Hastings et al. (2016) suggest that the nurses can be categorized into registered nurses (RNs), licensed practical nurses (LPNs), and health care aides (HCAs). The nurses should be assigned to cases they have expertise and experience. The move ensures the quality of service delivery and also promotes safety for the patients. Moreover, only the required nurses per shift will be assigned duties based on the current number of patients to help save on the costs. Overall, the proposed model aims to enhance quality, ensure safety, and reduce costs through collaboration practice and optimizing skills and experience.
Hastings et al. (2016) introduced a team-based care model in a general medical unit. The authors assessed the benefits of the suggested framework at Alberta Health Services, a provincial hospital treating more than four million people. The model was evaluated for a year, and it was concluded that it improved role clarity, the scope of practice, and patient care quality. In summary, the collaborative model enhances patient care and safety compared to the Total-Patient-Care framework and should be implemented for the organization considered.
The Total-Patient-Care framework is limited in terms of nursing care quality and safety. In this context, a new model was proposed (Team-Skill-Based Nursing Care Model) to address the challenges associated with the Total-Patient-Care system. The new model assigned the required number of patients to attend to patients based on their expertise and experience. Overall, it promotes quality, safety, and reduces unnecessary costs, and should be implemented by the organization considered.
Hastings, S. E., Suter, E., Bloom, J., & Sharma, K. (2016). Introduction of a team-based care model in a general medical unit. BMC Health Services Research, 16(1), 1-12.
Havaei, F., Dahinten, V. S., & MacPhee, M. (2019). Effect of nursing care delivery models on registered nurse outcomes. SAGE Open Nursing, 5(10), 1-10.
Havaei, F., MacPhee, M., & Dahinten, V. S. (2019). The effect of nursing care delivery models on quality and safety outcomes of care: A cross‐sectional survey study of medical‐surgical nurses. Journal of Advanced Nursing, 75(10), 2144-2155.
Vaismoradi, M., Tella, S., A Logan, P., Khakurel, J., & Vizcaya-Moreno, F. (2020). Nurses’ Adherence to Patient Safety Principles: A Systematic Review. International Journal of Environmental Research and Public Health, 17(6), 1-14.