Introduction
Care delivery can be designed in different ways. Usually, a healthcare facility selects a care delivery model and builds its work in accordance with the principles of this model. The choice of the model determines the processes of care delivery. There is a variety of care delivery models. There exist traditional models (including functional nursing, team nursing, etc.), evolving models (patient- and family-centered care), and innovative models (oriented on customer satisfaction). The current paper analyses two care delivery models, a patient-centered one which was identified in the process of practice setting observation, and a team nursing care model to contrast their peculiarities.
Practice Setting Observation: A Patient-Centered Nursing Care Model
During observation in a practice setting, which was a hospital, I have noticed the following aspects. First of all, patient care was provided with respect for patients’ preferences, and his or her needs and values were always considered. Secondly, I paid attention to efficient communication both between patients and staff and among the staff members, which was used to transfer the necessary information or during patient education interventions. Another impression of the activity of this hospital was the coordination and integration of all hospital services to make the treatment process comfortable for a patient. Patients could find emotional support from every staff member. Moreover, family members were also involved in the care process to make patients feel more comfortable. Finally, in the hospital setting, everything was designed for the physical comfort of patients and to enable their access to any service provided and to the necessary care. Thus, I could conclude that I was observing a patient-centered nursing care model.
Patient-centered care (PCC) is one of the evolving nursing care models. It developed during recent decades as a response to the Institute of Medicine’s recommendations about healthcare improvement (Lusk & Fater, 2013). However, patient care is not limited to nursing care but is a result of interprofessional team cooperation. The research by Lusk and Fater (2013) investigates the PCC model. The authors relate it to Watson’s theory that defined nursing as a holistic practice in which “human caring involves values, a will, a commitment to care, knowledge, caring action and consequence” (Lusk & Fater, 2013, p. 90). The research aims to examine the notion of PCC in scholarly literature and develop a nursing definition of this concept. The authors suggest the following implications to nursing practice. First of all, foundational behavior is important for PCC, and it includes “communicating and listening, treating the patient as a unique individual” (Lusk & Fater, 2013, p. 96). Moreover, it comprises patient learning, respect for patients’ values, and attention to needs.
Rathert, Wyrwich, and Boren (2013) investigated the outcomes of patient-centered care. Their systematic review of literature about PCC summarizes evidence from the most recent studies and makes conclusions about the application of PCC in contemporary care. This systematic review resulted in the development of a conceptual model that includes the PCC process, moderators, and mediators, as well as outcomes. The process comprises aspects that were already mentioned in the previous studies, such as respect for patients’ preferences, coordination of care, emotional support, family involvement, etc. (Rathert et al., 2013). As a result of these processes, three major outcomes are identified. They include patient satisfaction, patient clinical outcomes, and organizational outcomes. The authors come to the conclusion that further PCC efforts should be made to assess the effectiveness of this care model in different settings and with different types of patients.
Review of Team Nursing Care Model
Another nursing care model is team nursing. It is a traditional care model that was developed to address the need for professional care in conditions of registered nurses’ shortage. The research by King, Long, and Lisy (2014) investigates the effectiveness of team nursing. The authors claim that the team nursing model of care includes “a group of nurses who work as a team to deliver the care” (King et al., 2014, p. 60). This model makes use of different skills and qualifications that every team member has. The essence of the model is that the team works in collaboration and shares responsibility for patient outcomes. Moreover, the team nursing care model depends on a team leader. In this model, a leader is a registered nurse. To manage the team and care process, the team leader needs good communication and leadership skills (King et al., 2014).
Another research by Bowers and Nolet (2014) studies the application of a team nursing model in developing a Green House nursing home. The project of a Green House nursing home is concentrated on the issue of staff empowerment, which can provide both qualities of life to residents of a nursing home and quality of work life to its employees. In this nursing home, work is provided in self-managed teams and each of these teams is responsible for a certain part of work. While the research revealed different nursing care models in Green House nursing homes, the authors come to a conclusion that the use of these models is effective at different periods of time.
Discussion and Recommendations
In the observed care setting, the patient-centered care model is implemented successfully. However, this facility is well-staffed and equipped while other facilities may lack nursing staff or equipment to apply the PCC model. In the current setting, the PCC model comprises all the necessary components. It encourages patient autonomy and supports individualized patient care, creating a general caring attitude. Respect for values and response to patient needs make it perfect for patient satisfaction. Nevertheless, the model can be not effective in case of poor equipment and lack of financial supply of a healthcare facility. Thus, the self-care model can be applied to facilitate treatment and improve patient outcomes. While it is mainly executed by a patient, it demands much preparation and education from nurses. The major task of this model is to teach patients to take care of themselves to provide continuous care even after discharge from hospital. It enables patients to monitor their condition and visit a specialist in case of necessity. Moreover, it allows patients to stay active and independent in caring for their health.
Conclusion
On the whole, the choice of the nursing care model is a responsible step because it determines the further functioning of a healthcare facility. It influences both staffing policies and the organization of care process. Within a diversity of nursing care models, the patient-centered model proves to be effective for care organization as the most beneficial for patient satisfaction. However, different models can be applicable in different settings and be productive depending on the conditions of application. Thus, the selection of care model should be provided based on the current needs of a healthcare facility and it should be changed in case of necessity.
References
Bowers, B., & Nolet, K. (2014). Developing the Green House nursing care team: Variations on development and implementation. The Gerontologist, 54(Suppl 1), S53-S64.
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.
Lusk, J., & Fater, K. (2013). A concept analysis of patient-centered care. Nursing Forum, 48(2), 89-98.
Rathert, C., Wyrwich, M., & Boren, S. (2013). Patient-centered care and outcomes. Medical Care Research and Review, 70(4), 351-379.