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Overview of Patient Care Delivery System

Healthcare Delivery Systems

Improvement Project:
One to One Nurse Handoff

Total Patient Care Delivery System

Definition
o Total responsibility
o RNs have high autonomy

Bryanna Barcelo, Felicia Coiner, Tiffany Garcia, Paola Miramontes,

Jessica Rosenow

(Marquis & Huston, 2014)

Microsystem Model:
Leadership

Microsystem Mode
Organizational Culture and Support

Leadership Style: Democratic

oNursing Assistant
oRegistered Nurses
oCharge nurse
oNurse manager

Culture
oSupportive
oTeamwork
oFloat pool
oI.C.A.R.E.
Organizational Support
oRecognition for nurses/units
oUnit Care coordination
oSkills fair
Effect on Delivery of Care

How this Style Influences Care

oAutonomy
oClear goals
oSupports nursing needs
oPositive effects on outcomes
(Marquis & Huston, 2014)

(J. Tunnell, personal communication, September 15, 2015) 4

Microsystem Model:
Patient Focus & Staff Focus

Microsystem Model:
Interdependence of Care Team

Mission: Fulfill President Lincolns Promise

oTo care for him who shall have borne the battle and
for his widow and his orphan by serving and honoring
the men and women who are Americas Veterans.
Veteran-Centered
o Commitment to I.C.A.R.E
Staff-Centered
oTuition reimbursement
oPaid skills training
oSelective hiring

(US Department of
Veterans Affairs, 2015).

Care Provider Teamwork

oWillingness to help each other
oRespect
oCollaboration
oTrust
Teams Support of Patient-Centered Care
oEmbodiment of I.C.A.R.E
oRounding
(J. Tunnell, personal communication, September 15, 2015)

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Microsystem Model:
Use of Information and Healthcare Technology

Microsystem Model:
Process for Healthcare Delivery Improvement

BCMA
oScanning
CPRS
o Standardized
o Difficult to hack
VistA
Telehealth Services
Nurse badges

Nurses encouraged to improve practice

oV.A.L.O.R
oJournal Club
oSkills Lab
oQuality Fair
Care

Improvement

Microsystem Model:
Staff Performance Patterns

Specific Aspect Targeted for Improvement:

Process Improvement

Evaluation of Skills
oSkills fair

Yearly Evaluations
oNurse and Manager

Importance of Inpatient Surveys

Discharge Call Survey

Leading the Plan for Healthcare Delivery

Improvement

Implement One to One Nurse Handoff

Benefits to the Hospital
oLess overtime
Benefits to the Unit
o More organized
Benefits to the Nurse
o Less overwhelmed
Benefits to the Patient
oMore time for patient care
oFall risk increases(Isomi et al., 2013).

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References

Staff Presentation
oStep 1: Talk to staff
oStep 2: Talk to unit manager
oStep 3: Staff in-service
oStep 4: Implement with VA white belt
Plan for Successful Completion
oStep 5: Evaluation
oGradual changes

Isomi, M.M., Hempel, S., Ganz, D.A., & Shekelle, P.G.

(2013). Inpatient fall prevention programs as a patient
safety strategy. Annals of Internal Medicine, 158(5). p.
390-396. doi
10.7326/0003-4819-158-5-201303051-00005 .
Lacroix, D. R. (2015). Management, Leadership, Power and
Poli5cs [PowerPoint Slides]. Retrieved from hBps://
d2l.arizona.edu/d2l/le/content/434224/Home

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Marquis, B.L. & Huston, C.J. (2014). Leadership roles

and management functions in nursing: Theory and
application (8th Edition). Lippincott Williams and Wilkins.
ISBN Number: 13: 978-1-4511-9281-0.
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Reference
U.S. Department of Veterans Affairs. (2015). About VA:
Mission, vision, core values, and goals. Retrieved from
http://www.va.gov/about_va/mission.asp
U.S. Department of Veterans Affairs. (2015, June 3).
VistA. Retrieved from http://www.ehealth.va.gov/
VistA.asp

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