The health care delivery system in the US is nearing a crisis point, as the demand for expensive acute services grows in the face of looming shortages of key health care professionals. At the same time, new incentives are being created to reduce expensive, preventable hospital-based care. These trends create an undeniable need for new models of care delivery that can leverage new roles and technology to deliver care to more individuals at lower cost while preserving (and hopefully improving) patient quality, safety, and satisfaction.
At the beginning of 2007, the Robert Wood Johnson Foundation funded an original research project by Health Workforce Solutions LLC (HWS) to identify and profile new models of care that could be widely replicated throughout the United States.
Through a broad-based email inquiry, literature review, and Internet research, HWS generated nearly 200 leads and selected 60 care models for in-depth research interviews. In addition, HWS convened two groups of leading nurse executives, nurse academics, and health care executives to discuss criteria for ranking care delivery models and strategies to encourage model replication.
Carefully applying the ranking criteria listed below, HWS winnowed the group to 24 innovative care delivery models. Complete profiles of each of the 24 models, including a detailed description, impetus for its development, results, considerations for implementation and replication, and selected tools are published on this website.
HWS used the following criteria to identify and rank innovative care delivery models.
- Nursing care delivery model, or interdisciplinary care delivery models with a nursing component and an acute care interface
- Innovative, as demonstrated by one or more of the following changes:
- New roles for nurses and other professionals
- New roles for allied health professionals, students, or new graduates
- Use of new technology (or use of technology in a new and novel way)
- Redesign of physical layout, inventory, or other support systems
- Demonstrated positive impact on quality, safety, cost, and/or (patient or caregiver) satisfaction
- Potential to decrease long-term demand for acute care nursing through more effective leveraging of nurses
- Sustainability of model and ability to be replicated in other facilities or communities
- Primarily serves adult patients (>18)
These 24 models are intended to serve as a starting point in the development and propagation of innovative care delivery models. It is our hope that many organizations will peruse these models and find ideas and elements to adopt and adapt for their own patients. But the even greater hope is that these models will encourage and inspire continued innovation in care delivery.
Website visitors can question and comment on these models via the discussion board feature of the website. In addition, organizations are encouraged to share information about their own care delivery models with HWS. For more information about HWS, click here.
The HWS research team would like to express our sincere appreciation to each of the models profiled on this site for graciously sharing their time and expertise; to Susan Hassmiller and the staff of the Human Capital team at the Robert Wood Johnson Foundation; and to the following people and organizations. Without their contributions, this work would not have been possible.