Seton began training and implementation for the first unit adopting the Primary Care Team in 2000.  Each new unit took approximately nine months to implement the model.

Two of the original designers of the Primary Care Team model oversaw all the initial units during their implementation of the model.  They provided developed tools to help with education on the model, provided the education themselves, and provided onsite support.  Part of that support included mentoring unit leadership in change management, as many of the unit managers and charge nurses were new to their roles.  Recognizing, coping with and supporting staff as they demonstrated the normal behaviors of a major change was some of the most important work done during the implementation.  Unless the new model creates benefits that individuals truly value and want for themselves, the status quo is overwhelmingly favored, especially when things get hectic and chaotically busy.  Leadership had to learn that this is a common tendency when trying to change a culture, and how to support their staff to recognize the value of the change and establish the new culture in spite of difficult moments and challenges.

The value of the new care model had to be kept in front of staff constantly – patient safety, patient centeredness, support for new nurses, reduced turnover.  In addition, very simple measures were tracked prior to and after implementation to show staff the positive changes that were coming about with the care model.

The Primary Care Team enables Seton to confidently hire a large number of new grad RNs as the model builds in mentoring for new grads.

Initially, two of the original designers of the Primary Care Team model provided an extensive unit-based training on the model.

But now that the model has matured, Seton provides an extensive education program including self-paced training modules and classroom sessions taught by an in-house training team. The training team also conducts ongoing staff coaching and evaluation and also monitors quality and satisfaction outcomes.

The Primary Care Team has been widely implemented throughout the Seton Family of Hospitals; to date, 20 units across the system have adopted the model.  Most recently, Seton Shoal Creek Hospital, a mental health facility, implemented the model in three units.  Five Seton hospitals have implemented the Primary Care Team on its medical/surgical units.

Three Seton hospitals have implemented the model on Mother–Baby Units, where the model is different because the patients are different.  One nurse takes care of both mom and baby, and the CAs play a larger role. When there is no lactation consultant available, the RN provides lactation support, which increases workload.

ICUs have not adopted the complete model, but they incorporated some of the model’s elements, including more effective use of CAs and RN delegation of tasks.

The Primary Care Team is a model that can be adopted, in whole or in part, at a wide variety of acute care hospitals.  An important factor in the successful long-term implementation of the model is achieving strong buy-in from the nursing directors and clinical managers.