The delivery of care in a hospital, clinic, or another healthcare facility can be provided in different ways. Usually, a facility selects a model to follow and the process of care delivery follows this model. Among a variety of nursing care models, there are traditional ones such as functional or team nursing, evolving models such as patient- and family-centered ones, and innovative models, which are commonly oriented on patient satisfaction. This paper presents an observation in a practice setting where the patient-centered model was defined, the review of this care model, peculiarities of the team care model, and recommendations about nursing care models implementation.
Identification of a Nursing Care Model in Practice: Patient-Centered Care
The observation took place in a primary care hospital. I had an opportunity to visit the different units and noticed the following peculiarities of care. First of all, the process of care was organized concerning patient preferences. Thus, patients were involved in decision-making about their treatment. The second specific feature was a high level of care coordination. It was observed both in clinical care and in the functioning of ancillary and support services.
Another peculiarity was much attention given to the distribution of information and patient education. I had a chance to talk to patients and they shared that pre-discharge education is a focus of the hospital. Patients receive information and clear instructions about self-care and peculiarities of rehabilitation after they leave the health care facility. I can also emotional support from nurses, which is particularly important for patients who experience anxiety or fear.
Moreover, family and friends are highly welcome at the hospital. They are allowed to visit patients, participate in the process of care, and are also involved in patient education. Finally, an important observation is the availability of care. It is easy to make an appointment with a specialist, and there is a transportation service for disabled patients. Judging by my observations, I can conclude that the health care facility applies a patient-centered care model.
Review of Patient-Centered Nursing Care Model
Patient-centered care (PCC) can be defined as “care provision that is consistent with the values, needs, and desires of patients and is achieved when clinicians involve patients in healthcare discussions and decisions” (Constand, MacDermid, Dal Bello-Haas, & Law, 2014). This care model is expected to have advantages for patients since it provides better health outcomes, a higher rate of patient satisfaction, and the reduction of healthcare expenses, partially due to fewer readmissions. The scoping review conducted by Constand et al. (2014) reveals the following features of PCC mentioned in studies dedicated to the problem of nursing care models.
One of the significant components of this model is communication, which is characterized by sharing, compassionate care provision, and attention to patient needs. Another peculiarity to mention is a partnership, which comprises both relationship building with a patient and inter-professional collaboration as one of the conditions of favorable patient outcomes (Constand et al., 2014). Health promotion is also typical of PCC and implies an effective resource distribution and efficient management of patient cases. The authors conclude that while there is no unified model of PCC, it has many common features in different healthcare facilities. The most significant elements of the model are communication, partnership, and health promotion.
Patient-centered care is expected to result in better patient outcomes compared to traditional models. Research by Rathert, Wyrwich, and Boren (2013) provides evidence of patient-centered care’s impact on patient outcomes. The researchers develop a conceptual model based on the results of a review of recent studies. This model comprises the PCC process, moderators and mediators, and outcomes. The process involves aspects that were discovered in earlier studies, for example, respect for patients’ needs and wishes, high level of coordination of care, emotional support from the staff, family involvement, etc. (Rathert et al., 2013).
The researchers summarize their findings and conclude that there are three main outcomes of PCC application, such as patient satisfaction, patient clinical outcomes, and organizational outcomes. Moreover, the authors suppose that PCC can be successfully applied in conditions of diverse healthcare facilities with different groups of patients.
Review of Team Nursing Care Model
To oppose PCC, this review concentrates on the team nursing g care model, which is a traditional model of care. Its main goal is to react to the shortage of registered nurses and provide the necessary level of professional care. The study by King, Long, and Lisy (2014) discovers team nursing efficiency. The researchers state that the team nursing model implies “a group of nurses who work as a team to deliver the care” (King et al., 2014, p. 60).
The team nursing care model is grounded on diverse qualifications and skills that the members of the team possess. The idea of this model is cooperation and shared responsibility for the outcomes of care. Also, an important feature is that a team has a leader who manages the activities of other members. A registered nurse with developed leadership and communicative skills can be a leader for a team in this model (King et al., 2014).
The choice of team nursing as a model of care is discussed in the study by Fairbrother, Chiarella, & Braithwaite (2015). The researchers review the history of models of care development and analyze their application in contemporary healthcare settings. They relate team nursing to Rogers’ humanistic organizational psychology, which was popular in the 1950-s-70s and arose in team nursing at the beginning of the twenty-first century. The authors consider team nursing to be a highly professional model, which allows the development of multiple skills of its members.
Implementation and Recommendations
It can be concluded that the patient-centered care model is successfully implemented in the facility under consideration. However, the observation was provided in a hospital with excellent resources and proper staffing policies. In the case of understaffed facilities or those that lack funding, the PCC model can be not effective. This model can be recommended for healthcare facilities that value patient autonomy, can provide individualized patient care, and develop a caring attitude. When these conditions are met, the model is expected to be effective and result in better patient outcomes as well as high rates of patient satisfaction.
For facilities that lack staff or resources, a team nursing care model is acceptable. It implies the joint effort of healthcare professionals to provide better patient outcomes and guarantee their safety. Moreover, effective teamwork in a cooperative environment has the potential for increasing staff satisfaction.
To summarizing, it should be mentioned that the choice of a nursing care model depends on many factors including staffing of the facility and its available resources. The choice of a model determines peculiarities of care and influences patient outcomes. One of the effective contemporary models of care is a patient-centered model, which has a proved efficiency for better patient outcomes and their satisfaction. However, other models can be successfully utilized to provide high-quality care.
Constand, M., MacDermid, J., Dal Bello-Haas, V., & Law, M. (2014). Scoping review of patient-centered care approaches in healthcare. BMC Health Services Research, 14(1). Web.
Fairbrother, G., Chiarella, M., & Braithwaite, J. (2015). Models of care choices in today’s nursing workplace: where does team nursing sit? Australian Health Review, 39(5), 489. Web.
King, A., Long, L., & Lisy, K. (2014). Effectiveness of team nursing compared with total patient care on staff wellbeing when organizing nursing work in acute care ward settings: A systematic review protocol. JBI Database of Systematic Reviews and Implementation Reports, 12(1), 59-73. Web.
Rathert, C., Wyrwich, M., & Boren, S. (2013). Patient-centered care and outcomes. Medical Care Research and Review, 70(4), 351-379. Web.