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Models of Care: Healthcare Delivery


Healthcare delivery models always take into account several aspects. They clarify assignments and responsibilities and they delegate authority to nurses who can accomplish patient care at a high level. The main goal of different models is to maintain an effective patient-nurse ratio cost-effectively, and every model describes its methods to achieve this goal.

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Healthcare Delivery Models

The total patient-care model (case nursing) implies that RNs provide care for one patient or more during a shift. The nurse works in tandem with other parties connected to healthcare services: patients, families, and team members. The continuity of care within the shift and patient-nurse interaction are the main advantages of this system. Functional nursing implies that nursing activities are assigned to functional units and that nurses perform specific tasks across a variety of patient types.

Despite the division of labor, this model does not enable autonomy or encourage professional development (Fernandez, Johnson, Tran, & Miranda, 2012). Moreover, in this case, it’s only the charge nurse who bears the high responsibility of coordinating care.

Collaboration with Healthcare Provider

Team nursing implies that the RN applies leadership and supervision to coordinate a small group of ancillary personnel to care for a small group of patients. Tasks are delegated and performed by the skills and scope of practice of each team member. A patient care, in this case, is less fragmented; however, one of the main complications is communication within the team. Primary nursing is patient-centered and assumes 24-hour responsibility and accountability by the RN in terms of planning, directing, and assessing a patient’s care, from admission to discharge.

The following model allows for an ongoing holistic approach to healthcare and encourages the nurse’s autonomy (Fernandez et al., 2012). Still, a high level of performance and responsibility is expected from these nurses. Another model is case management, where RNs plan and supervise the processes involved in providing care to patients with complex healthcare problems.

Variables that Influenced the Healthcare Delivery System and the Practice of Nursing

Although most institutions utilize several delivery models toward higher flexibility of activities, there might be situations when nurses need to cooperate with other healthcare providers. The need for consultation and collaboration with different personnel arises when a situation goes beyond the RN’s level of expertise, or if there are no available resources to perform necessary healthcare tasks (Bridges, Davidson, Odegard, Maki, & Tomkowiak, 2011).

Frequently, cooperation is needed to ensure correct diagnoses and to define a further course of action. Moreover, patients who consider a course of treatment to be inaccurate tend to request a second opinion to learn about alternative solutions for care. In any type of situation, patients and their interests remain paramount. Through consultation and collaboration, nurses can decrease medical mistakes and emphasize proper healthcare delivery.

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Several variables have significantly influenced the healthcare delivery system and the practice of nursing. Enhanced healthcare has increased life spans (Masters, 2015), while increased population and new levels of diversity in terms of cultural and economic backgrounds have provoked a change in healthcare delivery approaches. Increased cultural diversity is the consequence of high immigration levels during recent decades.

It implies that nursing staff should be able to address the needs of a multicultural society with respect and tolerance toward differences imposed by diverse cultural attitudes and perceptions about patients. Moreover, the number of patients with AIDS, tuberculosis, and sexually transmitted diseases has grown and the course of their treatment requires constant innovation (Masters, 2015). However, technological advancements have enabled nurses to perform diagnostic and surgical activities at a higher level and have allowed conducting remote treatment and counseling.


Nonetheless, costs related to healthcare have increased drastically, while many people still have only limited access to services. Nurses have to show high productivity while performing a variety of activities, which often leads to nursing burnout. Today, the staff is challenged to provide high-quality healthcare while at the same time being pressed for resources; many people do not have insurance coverage, and institutions experience an increase in nurse turnover.

The nursing shortage is being addressed through the short-term (employing foreign nurses) and long-term (educational programs, incentives) solutions. Despite measures taken to improve the situation, nursing issues are far from being resolved.


Bridges, D.R., Davidson, R.A., Odegard, P.S., Maki, I.V., & Tomkowiak, J. (2011). Interprofessional collaboration: Three best practice models of interprofessional education. Medical Education Online, 16. Web.

Fernandez, R., Johnson, M., Tran, D. T., & Miranda, C. (2012). Models of care in nursing: A systematic review. International Journal of Evidence-Based Healthcare, 10(4), 324–337.

Masters, K. (2015). Role development in professional nursing practice. Burlington, MA: Jones & Bartlett Learning.

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