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An advanced nurse practitioner-led service - consequences of service redesign for managers and organizational
1Department of Nursing, College of Human and Health Science, Swansea University, Swansea SA2 8PP, UK. T.D.Barton@swansea.ac.uk
Aim:
A service review of a secondary care advanced nurse practitioner-led service.
Background:
An acute hospital-based elderly care rehabilitation service evolved over a 9-year period from a traditional consultant/junior doctor configuration to a consultant/advanced nurse practitioner configuration. The review evaluated the advanced nurse practitioner team's role in the clinical setting, and the constraints experienced as a result of the traditions of the hospital organization.
Evaluation:
The review drew its conclusions from opinion data collected from 38 professionals and non-professionals within the rehabilitation service.
Key Issues:
The organizational infrastructure and traditions that had an impact on service delivery by the advanced nurse practitioner team. There is a demand for senior management to act on developmental constraints.
Conclusions:
The advanced nurse practitioner-led rehabilitation service was fit for purpose and an emerging model of a non-medical led care. However, important organizational constraints were identified.
Implications For Nursing Management:
An advanced nurse practitioner team, working in collaboration with medical consultants, was a model for future service redesign in the acute hospital setting. Nevertheless, it presented challenges to senior health-care managers on current organizational infrastructures.
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