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Published on: February 16, 2011
Care redesign: a higher-quality, lower-cost model for acute care
Pamela T Rudisill1, Carlene Callis, Sonya R Hardin
1Author Affiliations: Senior Vice President and Chief Nursing Officer (Dr Rudisill), Community Health Systems, Franklin; and Assistant Vice President Strategic Resource Group, Vice President Strategic Planning American Group (Ms Callis), HCA, Nashville, Tennessee; Professor (Dr Hardin), College of Nursing, East Carolina University, Greenville, North Carolina; and Professor Emeritus (Dr Dienemann), School of Nursing, UNC Charlotte and Nurse Researcher Carolinas Medical Center University, North Carolina; and Chief Nursing Executive (Dr Samuelson), Poplar Bluff Regional Medical Center, Missouri.
A new RN-led care team model improved nurse satisfaction and reduced costs on medical-surgical units. While clinical outcomes improved, patient falls remained an exception.
Area of Science:
- Nursing Care Delivery
- Healthcare Management
- Team-Based Care Models
Background:
- Healthcare systems face economic pressures and evolving regulations.
- Optimization of nursing services and support staff is crucial.
- Increased capabilities of nursing professionals necessitate new care models.
Purpose of the Study:
- To design, pilot, and evaluate a shared accountability care team model.
- To assess the impact of this model on medical-surgical units.
- To explore innovative nursing care delivery strategies.
Main Methods:
- A pilot study of an RN-led team model with shared accountability was conducted.
- The model was implemented on 3 medical/surgical units for 6 months.
- Nursing staff received comprehensive training and support.
Main Results:
- Significant improvements in nurse satisfaction were observed.
- Positive trends in clinical outcomes and patient experience, excluding falls.
- Reduced salary costs and a decrease in case mix-adjusted length of stay.
Conclusions:
- Innovative nursing care models can enhance quality and satisfaction.
- Shared accountability teams offer a viable solution for cost reduction.
- This model demonstrates potential for maintaining clinical quality while decreasing healthcare costs.
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