Caring Delivery Model Toolkit

Defining the Clinical Caring Team (pdf)
A short list of the roles and responsibilities of the Clinical Caring Team members, including the Team leader, the RN and Patient Care Associates.

Attributes of the Nurse Caring Model (pdf)
A bulleted list of necessary attributes in making the Caring Model work.

Overview of Jean Watson’s Theory (pdf)
An outline of key beliefs of Jean Watson’s Theory of Transpersonal Caring.

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Available Resources

Synopsis of Reviewed Research Related to Watson’s Theory (pdf)
Key findings of reviewed studies highlight caring behaviors and the benefits of a caring nurse.

Reference List (pdf)
References to Watson’s work, as well as other nursing models, nurse caring, education, and theories.

A Patient’s Story
The story of one patient’s experience and the kindness he finds in his caregivers.
Schwartz, Kenneth. “A Patient’s Story.” Boston Globe Magazine. 1995 July16.

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For More Information

For any questions not answered by materials provided within this profile, please contact

Ruth Walton Regional CNO
Vanguard Health Systems
132 Turnpike Road, Suite 200, Southboro, MA 01772
email: RWalton@vhsnewengland.com

Utilization

Anecdotally, MetroWest Medical Center (MWMC) observed that after implementation of the Nurse Caring Delivery Model, overtime costs and contract labor costs decreased, as did staff turnover and absenteeism on the units.

Patient

In order to provide more transparency to the public about nursing staffing and quality outcomes, the Massachusetts Hospital Association and the Massachusetts Organization of Nurse Executives are tracking selected quality indicators  that are sensitive to the availability of nurses.

Data was collected for both March and September 2007 and published on a website called Patients First.  The results for MWMC are as follows:

  • Pressure Ulcer Prevalence, Acute Care Med-Surg Combined:  Framingham Union Hospital rate of 3.27 percent compared to peer group rate of 2.64%.  Leonard Morse Hospital rate of 1.16 percent compared to peer group rate of 2.64%.
  • ∑ Patient Falls with Injury, Acute Care Med-Surg Combined:  Framingham Union Hospital rate of 0.82 percent compared to peer group rate of 1.00.  Leonard Morse Hospital rate of 0.42 percent compared to peer group rate of .82%.

Provider

Since implementing the Nurse Caring Delivery Model, RN turnover rates at MWMC have steadily declined from 14 percent in 2002 (when the model was being implemented) to 11 percent in 2003 to 10.5 percent in 2006 to 9.8 percent in 2007.

MWMC assesses nurse satisfaction using the Data Management and Research Employee Satisfaction survey, in which employees are asked to rate their answers using a one to four scale.  Results from the 2006 survey are provided below.  

  • “The extent to which you enjoy the work that you do.”  MWMC 3.38 versus national norm 3.35
  • “Your attitude about working here.”   MWMC 3.35 versus national norm 3.20
  • “The extent to which you are challenged by your work responsibilities.” MWMC 3.38 versus national norm 3.26
  • “Your satisfaction with this organization as a place to work.”  MWMC 3.21 versus national norm 3.09
  • “You have a mentor in this organization who encourages your professional development.”  MWMC 3.02 versus national norm 2.84

Patient

Prior to beginning the pilot of the model in 2002, MetroWest conducted a study of call light utilization by patients for a period of a week.  Three months post implementation, the hospital repeated the study and found that call light utilization was reduced by 60 percent.

According to November 2007 Press Ganey scores for “overall satisfaction” of patients cared for on inpatient units, both Framingham Union Hospital (FUH) and Leonard Morse Hospital (LMH) are in the top quartile when compared with the entire Press Ganey database of over 1500 hospitals.  Additionally, the scores related to “Overall Satisfaction with Nursing” for the same time period place FUH in the top five percentile and LMH in the top thirty percentile of the entire Press Ganey database.

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