The driver for developing a new care delivery model was the dissatisfaction CNOs were experiencing with task-oriented care delivery models, currently in place in their hospitals, and concerns about the lack of a coherent approach to the delivery of care on inpatient units.
Specific goals of the model included:
- Developing a coherent care model across the hospital and the system.
- Eliminating task-based approaches of typical nurse practice models.
- Implementing a new model that encouraged continued improvements in care quality and created a sense of team and interdependence amongst caregivers.
In late 2002, the Chief Nursing Officer of MetroWest Medical Center led an initiative to design a new care delivery model for the Central Northeast Division of Tenet Healthcare. This work continues today under new owner Vanguard Health Systems and has been expanded to include other hospital facilities.
MetroWest’s CNO conducted a literature review and national search for a new care delivery model and found no models that had the attributes that she felt would be essential. However, she found inspiration in the writings of Kenneth Schwartz, a Boston-based attorney, about his experience with terminal cancer. Despite suffering through the harrowing experiences of chemotherapy, radiation, and surgery, Schwartz’ ordeal, he wrote, was punctuated by moments of exquisite compassion and simple acts of kindness. “The simple human touch from my caregivers – have made the unbearable bearable”.
Kenneth Schwartz’s experiences resonated deeply and created the impetus to develop a new model of care that provided compassionate care to all patients at MWMC. The CNO saw the opportunity to do this by operationalizing key elements of Jean Watson’s Theory of Human Caring into a structured care delivery model. The new model was called “A Nurse Caring Delivery Model” to emphasize the guiding philosophy and core value of caring as an essential, underpinning of nurses’ work.
