The implementation of the Primary Care Team model has been correlated with decreases in mortality rates and decreases in the occurrence of pressure ulcers.
In addition, one maternity unit experienced an impressive reduction in errors as a result of implementing the Primary Care Team; during the six months following implementation of the model, medication errors dropped 77 percent compared to the six months prior to implementation.
After the implementation of the care model on one unit, unwitnessed falls decreased by half for three months in a row. In addition, on some units, both physicians and managers noticed professional growth and improvement in critical thinking skills in the nurses.
Anecdotally, team members and physicians on units that have implemented the Primary Care Team have been satisfied with the new model, especially with team effectiveness.
New nurses expressed relief that they received assigned support in the person of the RN Care Manager, and were not “out there alone” in the unit. Nursing students expressed a higher confidence working in units due to being connected to a team with oversight from an experienced nurse. A high number of traveling nurses convert to permanent staff due to the support they receive from the Primary Care Team.
Results from surveys given to providers before and after implementation showed improvements in the use of experienced RNs. Physicians showed a 13% increase in perception of availability of an experienced RN. Physicians also noted increased satisfaction with timeliness, thoroughness and accuracy of reports received on the status of their patients.
In the year after implementing the Primary Care Team, one unit experienced a 64 percent reduction in RN staff turnover. In another unit, RN turnover was reduced by half in the quarter after implementation of the model, and by half again in the following quarter. In another unit, implementation of the care model demonstrated an excess of novice LVN’s on the night shift, with not enough RN’s to provide the required oversight. As a result, staffing was shifted to better spread the novice nurses throughout the twenty-four hours and, thus, provide adequate oversight and ensure patient safety.
Following implementation of the Primary Care Team, many newer staff noted that they had enjoyed a “work-free” lunch for the first time since coming to work in the unit. Similarly, nurses expressed satisfaction with leaving work on time much more consistently, thus saving the unit money in “incidental overtime.”
Clinical Assistants expressed improved morale and a higher satisfaction in the work environment, noting that they felt more like a true team member with information to report to the nurse in team huddles, and with a nurse to prioritize and limit the work given to the CA. Previously, CAs felt like they were at the beck and call of every nurse in the unit. The RN recognized increased CA accountability and felt that the CA actually completed a larger percentage of activities assigned to the CA.
Anecdotally, patients and families have repeatedly expressed satisfaction with the care they receive from the Primary Care Team. One specific comment heard repeatedly in the informal narrative surveys was that the call lights were answered so promptly. Other patients expressed surprise when asked, “What is the most important thing we can do for you this shift?” Many stated they had never been asked that question before. Patients’ families expressed their satisfaction with having the nurse’s name on the white board – it helped them know who to ask for if they needed information. Even the physicians appreciated that piece, as they sometimes did not know which nurse had assumed care of their patients unless they saw the name on the board.
