An Aging Population With Chronic Disease Compels New Delivery Systems Focused on New Structures and Practices

Abstract

Patients now, more than ever, need reassurance that they are indeed the focus of the healthcare team. Patients enter the healthcare system knowing that there are worldwide shortages of key personnel, that physicians can no longer afford malpractice coverage and are many times practicing "defensive medicine," and that there are reported issues in terms of patient safety that may affect their own care within a hospital setting. With inpatient care becoming increasingly focused on "curing" via application of new and advanced technologies, patients are beginning to ask the question "Does anyone care?" To answer that question, Baptist Hospital of Miami, part of Baptist Health South Florida, committed to the hospital-wide implementation of a new model of practice. In this model, a patient care facilitator (PCF) becomes the primary point person for the patient during their stay. Each PCF leads a "Twelve Bed Hospital," a smaller segment of the patient care center where staff work with the PCF to make the whole inpatient experience more personalized. Initial results of the pilot implementation are promising. Research is underway to assess the overall effects of this practice model on continuity of care, patient safety, satisfaction, efficiency, and effectiveness of patient care.

Population Aging and the Future of Canadian Healthcare

“…Since the healthcare system is currently based on an acute care model, healthcare services to deal with chronic illnesses associated with advanced age are "fragmented and poorly integrated with community services (Bierman, 2012, p. 1)" and are perpetuating in high costs to the healthcare system. The current acute care model in Canada is cure-focused, and as Shinkus Clark (2004) point out, the "cure" usually involves a series of consults where the nurses usually end up interpreting for physicians as physicians do not always communicate directly (p. 106). This greatly increases the length of time that is takes to cure an illness and can end up raising healthcare costs even more if the patient's condition worsens in the meantime and requires additional treatment or hospitalisation.…”

Umsorgt werden und umsorgen: Leben mit mehreren Langzeiterkrankungen (Leila) – Eine qualitative Studie zum Beitrag von APN in integrierter Versorgung

“…Gemäß Studien fokussiert die Medizin vermehrt auf Krankheitsbehandlungen und Techniken («curing»), während chronisch Kranke zunehmend fragen: Kümmert sich überhaupt jemand um uns? (Clark, 2004). Die Unterstützung im Erleben des Krankseins und das Verstehen von Krankheit sind für multimorbide Patient(inn)en von großer Bedeutung (Kitson, Marshall, Bassett & Zeitz, 2012).…”

The Quest for New Innovative Care Delivery Models

“…Patient care facilitators are responsible for mentoring other nursing team members (RNs and patient care technicians) in their 12-Bed Hospital. 2 Patient care facilitators are specialty-certified, baccalaureate-prepared RNs with at least 3 years of experience. Of the 40+ PCFs on staff at Baptist, 50% of the PCFs are nurse practitioners, clinical nurse specialists, and clinical nurse leaders with advanced nursing degrees.…”