Implementing New Models of Care: Leadership Reflections and Recommendations

Nursing leaders are considering new models of patient care delivery to combat the continuing workforce challenges and an increase in patient acuity. The nurse manager is essential in the successful implementation of a new care model; however, little is known about their experience leading their team through such a significant change. A large health system in the mountain west successfully implemented a new team-based patient care model, called Partners in Care, on 11 medical-surgical units. The model's intention was to build effective teams and improve workforce outcomes through registered nurses (RNs) and unlicensed assistive personnel (UAP) functioning as partners in care delivery. The goal of the model was to ensure RNs were surrounded with the necessary support to empower top-of-scope practice. As a part of the project, 3 of the first nurse managers that implemented the new care model completed a question-guided reflection exercise of their journey. Through their reflections important aspects of resources, professional governance, communication, monitoring/adjusting/sustaining, celebration, and leadership support were highlighted. Recommendations for those beginning their journey include consideration of nurse manager workload and competencies, taking a phased approach, and including important partnerships.