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Cleveland Clinic’s Patient-Centered Nursing Model


Globally, healthcare systems are under immense pressure to augment efficacy, manage cost, account for and document approaches adopted and validate the effectiveness of used methods. Furthermore, awareness among patients on care and medication has massively increased and, therefore, high expectations from care models are apparent.

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Moreover, nurses and health care providers need professional autonomy and opportunities to employee their expertise and skills (Mattila, et al., 2014).

Therefore, there are needs to appraise nursing care models and investigate the key roles they play in providing the required infrastructure in care delivery. In addition, nursing care models are a reflection of different philosophical foundation and organizational leadership.

This paper discusses some of the commonly adopted nurse caring models. One of the models discussed is the patient-centered model adopted by the Cleveland Clinic health system.

A Nursing Care Model in Practice

The Cleveland Clinic Health System Nursing Model

With a number of hospitals, institutes, and other programs, Cleveland Clinic health system employs approximately 11,000 RNs and 800 APNs (Small & Small, 2011). There are deliberate efforts to standardize care delivery throughout the various programs in the nursing practice. In addition, the nursing practice at Cleveland Clinic system strives to offer world-class services (Small & Small, 2011).

It is of paramount importance to note that Cleveland Clinic has a guiding principle that places the patients at the center of focus. As such, the clinic adopts the patient-centered care model.

With the model, nurses play key roles, especially in influencing patients’ perceptions. The leadership is responsible for the implementation of policies.

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Meanwhile, the patient is responsible for making informed decisions regarding care delivery and nursing practice. On the other hand, clinicians are tasked with ensuring that informed decisions are made and treatment is individualized to meet patient’s needs.

Literature review

Articles on Patient-centered Nursing Model

Hughes (2011) suggested that the patient-centered model is a key concept care delivery in many healthcare systems. As such, the model has been in use for a considerable time in history.

However, a number of challenges, including inconsistency in definition, have oftentimes hindered effective implementation. The article, therefore, endeavors to give a standard definition, which highlights the individualizing and customizing care to patients and reconfiguring patient-clinician relationships.

Moreover, the Hughes’ paper reviewed six scholarly articles to evaluate and share some of the key challenges and impacts of adopting the patient-centered model in nursing practice. Apart from the definition issue, the paper focused on describing the model’s essential components and strategizing on how to educate clinicians regarding effective patient-centered care delivery.

The article is concluded by the view that although the patient-centered model is vital in care delivery, it faces various challenges. A key challenge in the implementation processes the lack of proper understanding of roles yet all stakeholders advocate for their voice to be heard. Therefore, there is need to consistently understand the patient-centered care and clearly define stakeholders roles in the patient-centered model.

Jayadevappa and Chhatre (2011) asserted that adopting and implementing the patient-centered care model enhances effectiveness in resource management, patient’s outcomes, and improved satisfaction.

The model represents a reverence for patient’s experience, principles, requirements, desires and preferences during planning, co-ordination, and delivery in nursing practice. Jayadevappa and Chhatre (2011) emphasize the need for therapeutic patient-clinician relationships.

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Carrying out a systematic review on 14 articles, Jayadevappa and Chhatre (2011) found that patient-centered model has various promising attributes for augmenting nursing practice, reducing cost, and improving satisfaction.

Nevertheless, the model the spread and acceptability of the model is highly hampered by the lack of leadership and efficacy in the integration of policy measures. In addition, there is a lack of consensus on how to evaluate and make reports on the model.

The paper suggests that evaluation measures should reflect the key concepts of the patient-centered model to ensure adequate knowledge among patients. Therefore, decision-making processes are adequately informed.

The article is concluded by emphasizing the need for quality decision making and giving a clarity on the interaction of patient-centered care and evidenced-based care. It is evident that patient-centered care and evident-based care complement each other and should be adopted in nursing practice to enhance clinical relationships.

Articles on Primary Care Nursing Model

Johansson, Lundström, and Susanne (2015) based their paper on a study done on nurses pertaining the adaptation of primary care model and its emotional effects, which affects job satisfaction.

The results of the study indicated that there were considerable degrees of uncertainty, lack of clarity, and overriding of roles and responsibilities. As such, there is the need to clarify nurses’ roles, which include educating patients.

Decisively, adopting primary care model to nursing practice, especially in haemodialysis nursing and other long-term illness, is impactful. It is of paramount importance that psychological counseling is provided to healthcare providers to boost emotional state.

Mattila et al. (2014) carried out a study on primary nurse model, which they said has gained prominence since the 1980s.

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The study revealed that effective implementation of primary nurse model in nurse practice may have augmented results, especially in maternity care. In addition, the model significantly improves job control and autonomy. However, lack of sufficient research results in less evidence of positive effects on for nursing staff.

The article was concluded by emphasizing the need for more research and studies on primary nurse model. Further research would be vital in cost management, job satisfaction, and staff retention in systems that adopt the primary nurse model. In addition, research is vital in the numerical evaluation of outcomes.

The Implementation of the Patient-Centered Nursing Model in Cleveland Clinic Health System

The Cleveland Clinic health system is committed to the execution of the patient-centered model, which was launched in 2010 to 500 nurse managers. The model is incorporated with the Nursing Institute motto and the philosophy of passion for nursing.

Moreover, a program known as The Patient Experience, which is centered on the delivery of world-class care based on real-life feedback and testimonials. Furthermore, mandatory training and sensitization among the nurses are done using exclusive toolkits, online educational modules, and onsite presentations. Every nurse, therefore, is assigned the role of implementing and executing the model.

The Nursing Institute is responsible for the evaluation and tracking of the model’s success, which is based on assessing improvement in how patients perceive care delivery in Cleveland Clinic health system.

Recommendation for an Alternative Model

The Transitional Care Model

Cleveland Clinic health system can adopt the Transitional Care Model to augment patient outcomes and employees’ satisfaction. The Transitional Care Model has been rigorously tried and tested and it is evident that the model is consistent in augmenting efficacy and addressing numerous health care needs at relatively lower cost (Hirschman, Shaid, McCauley, Pauly, & Naylor, 2015).

TCM is a nurse-led and team-based intervention based on nine core components, including screening, staffing, maintaining relationships, engaging patients/caregivers, assessing/ managing risks and symptoms, education/promoting self-awareness and management, stakeholders’ collaboration, continuity, and coordination.

TCM allow care delivery and coordination from APRNs with high consideration of all stakeholders, including patients, caregivers, and physicians among others. Research has linked the TCM model to augmented care delivery, improved patient and caregiver outcome, and reduced cost.

In addition, TCM can be adopted by patient-centered medical homes (PCMHs).

The model is recommended for Cleveland Clinic health system since it emphasizes goal identification, designing and effective implementation of care procedures/programs, and care continuity.


Apparently, there are different nursing models, which are adopted by various health care systems. The models have unique features that make them adoptable to specific nursing practice. Moreover, leadership styles and guiding principles inform the decisions of selecting a particular model in a specific nursing setting.

This paper has discussed some of the commonly adopted nursing models, including patient-centered model, the primary care model, and the transitional care model (TCM).

The adoption and implementation patient-centered were observed in the Cleveland Clinic Health System. It is evident that the model is appropriate to health care systems that emphasize the need to put the patient at the center of health care delivery. However, the model is faced with some challenges that include clarity on definition and roles and responsibilities. Consequently, the TCM model is recommended as an alternative nursing model.

The paper provides some insight regarding nursing models. As such, I have learned that each model has key distinctive features and faces unique challenges during implementation. Therefore, appropriateness and effectiveness of a model should be considered before it is adopted to any nursing practice.


Hirschman, K. B., Shaid, E., McCauley, K., Pauly, M. V., & Naylor, M. D. (2015). Continuity of Care: The Transitional Care Model. OJIN: The Online Journal of Issues in Nursing, 20(3).

Hughes, R. G. (2011). Overview and Summary: Patient-Centered Care: Challenges and Rewards. OJIN: The Online Journal of Issues in Nursing, 16(2).

Jayadevappa, R., & Chhatre, S. (2011). Patient Centered Care – A Conceptual Model and Review of the State of the Art. The Open Health Services and Policy Journal, 2011(4), 15-25.

Johansson, P., Lundström, K., & Susanne. (2015). The primary nursing care delivery system within a haemodialysis context – experiences of haemodialysis primary nurses in Sweden. Clinical Nursing Studies, 3(4), 7-14.

Mattila, E., Pitkänen, A., Alanen, S., Leino, K., Luojus, K., Rantanen, A., & Aalto, P. (2014). The Effects of the Primary Nursing Care Model: A Systematic Review. Journal of Nursing & Care, 3(205). Web.

Small, D. C., & Small, R. M. (2011). Patients First! Engaging the Hearts and Minds of Nurses with a Patient-Centered Practice Model. OJIN: The Online Journal of Issues in Nursing, 16(2).

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