Care Delivery Model Toolkit

Patient Care Coordinator Job Description (pdf)
High Point Regional Health System’s job description for the new role of PCC.

Available Resources

The Quest for New Innovative Care Delivery Models.
Kimball, B. et al.  Journal of Nursing Administration.  September 2007.  392-398.

High Point Regional Health System Website

For More Information

For any questions not answered by materials provided within this profile, please contact Karen Gammons at kgammons@hprhs.com or Sharon Mitchell at smitchell@hprhs.com.

Drivers

The development of the Collaborative Patient Care Management model originated in hospital-wide efforts to balance quality, cost, and care delivery processes.  Improving patient care quality, in particular, was one of the key drivers of the model’s development, as was developing a more integrated case management and discharge planning model.

Specific goals of the model include:

  • Promote health awareness, prevention, disease management, and patient education across the continuum of care.
  • Actively involve patient and family in care plan and delivery.
  • Encourage collaborative practice among multidisciplinary team members.
  • Improve performance through measurement of clinical, financial, and customer satisfaction outcomes.

Origin

In the summer of 1992, the founder of the model attended a week-long intensive training session at the Center for Care Management in Natick, Massachusetts where she gathered many useful tools (e.g. care maps, road maps) that were eventually used in the development of the new model.  In addition, the model’s founder visited a hospital in Winchester, Virginia to observe their care delivery model.

She concluded that many of the nursing-based programs eventually morphed into utilization management functions.  In addition, she wanted to keep the model focused on the patient.  As a result, the focus for developing a new model became making the patient central to care delivery, while lessening concerns of families.  The new model is based on three tenets:  process, quality, and cost, with the patient considered as the center for the tenets.