The healthcare system has been on a continuous process of change informed by the need to improve patient outcomes. The nurses are trained and prepared to manage patients based on their needs and the environment within which they pursue a livelihood. However, it is evident that despite a standardized curriculum having been adopted over time, there are varying differences across various healthcare facilities and institutions on how care is managed or delivered. The big question that one may ask is how these differences emanate while we have a curriculum and a code of ethics as well as scope of practice that dictates the role of the nurse in various situations within the healthcare facility. The scope of nursing and the responsibilities of nurses do differ mainly based on the academic qualifications, certification as well as experience. However, these only serve to determine the separation of duties for nurses and therefore ensure that the care is not fragmented (Finkelman, 2012).
Across various healthcare institutions, there are notable differences in the way care is managed or delivered. It is this that can be described as the overall effect of adoption of different care models tailored for each facility. Care models dictate the organization of care delivery and this is determined by factors such as leadership beliefs and values, economic status or issues, the power and ability to recruit staff and retain staff as well as the mission of the organization. Apparently, the aspect of patient safety and quality of care cannot be overlooked in determining the nursing model of care delivery that is to be adopted by an organization (Finkelman, 2012).
Differences in roles within organizations as well as differences in patient populations may call for different care models. This implies that some patient populations will be suited to a particular model and others will be suited to a completely different model even if served by the same personnel within a similar location or residence. In essence, the needs of various patient populations differ and these needs may dictate how the nurses approach the care process so as to balance the issues of costs, quality of care and patient safety appropriately. Working at a geriatric care center is recognized the practical application of the interdisciplinary care model. This model is based on the need to recognize that each personnel or professional has a specialty and a strength that makes them stand out from the rest. However, no one aiming the professionals will possess all the capabilities and strengths to achieve or help meet all the patient needs. Each person has to play a particular role so that these sub-roles can be combined and ultimately lead to a desired outcome.
In this geriatric unit, there were six sets of staff; the three RNs who supervised the work of the nurses on shifts or collaboratively, the six physicians who attended to the patients and worked directly with the RNs to issue orders and monitor patient progress and review care plans and the UAPs who worked as the staff nurses tasked to do hourly rounds across the geriatric unit wards to ensure patients needs are met at all times. The other set of staff or personnel included a respiratory therapist, a physiotherapist, three social workers and a psychologist. The personnel worked collaboratively and communicated at optimal level to ensure integrated care processes.
According to Quintero (2004) the interdisciplinary care delivery model consists of six elements namely accountability, responsibility, authority, communication, clinical competence and resource management. The interdisciplinary care delivery model is built to maximizing the benefits that each of the personnel brings to the unit by affording them more responsibilities and increasing their impact on the ultimate results. Quintero (2004) notes that in as much as the patients’ needs are diverse as presented, when the healthcare facility has developed effective communication channels for its workforce then there is no fear of fragmented care even when the roles are significantly separated. Each of the members develops a sense of responsibility and recognizes that they owe so much to the others within the team and that without them he or she cannot function as effectively as they are expected.
Gathright, Holmes, Morris & Gatlin (2015) in their study focus on determining the importance of interdisciplinary care models within an inpatient child psychiatry unit. The researchers note that these units are mainly characterized by highly changing needs for the patients which in most cases are specific to the patient. There is little generalization in such units and therefore the level of accuracy is a key element to ensure that the developed care plans meets the goals desired for the patient. In this case, the authors are of the view that due to these changing needs, such inpatient psychiatry units need a continuous innovation process and this is best possible when there many minds are involved in an open process of change and thus suitable best to adopt the interdisciplinary module of care.
One thing that is clear on this interdisciplinary model of care is that it is more concerned about the care process. The model is built on primarily focusing on optimizing the care process and ensuring that the process is not hindered. It assumes that once the process of care is smooth, then the outcomes are positive or as desired. The actual preferences of the patient are significantly sidelined as long as the key players deem the level of collaboration, team work and communication good enough to meet the needs of the patients from a general perspective (Finkelman, 2012).
The synergy model of care delivery takes a different approach that places the patient at the helm of the care process and the competencies of the nurse at the other helm. This model is based on the need to recognize that each patient has unique characteristics and that these characteristics if maintained at the equilibrium will assure the patient of a health status. However, these can only be balanced if the characteristics are etched with the competencies of the care team (Kaplow & Reed, 2008). Each nurse is prepared in such a way that they can handle a particular need and not the entire needs of a patient. This model therefore provides for a situation where we can recognize that some of the patient characteristics are not met and therefore determining the right personnel to accomplish this task. The synergy model avoids the assumption of the interdisciplinary model that the care process if streamlines can assure of positive results or outcomes (Kaplow & Reed, 2008).
Conclusion
The interdisciplinary model of care delivery on the other hand has its focus on justifying that once the care process is suitable and satisfying to the nurses and the personnel involved then the outcomes will be maximized. The synergy model is adopted within the geriatric care unit can indicate better outcomes and maximize the role of each of the personnel. The synergy model seeks to have each of the healthcare personnel involved working closely with the patient to define their needs and therefore work towards those needs. In essence, the patient has to be afforded the satisfaction that is not defined by a predetermined process of care but on that is determined by their needs and how they would want their needs to be met (Kaplow & Reed, 2008).
The contemporary healthcare setting is shifting to a position where the patient needs are the primary focus and the status quo of bureaucratic processes is being out phased. Patient outcomes are being measured on quality of care, patient safety and patient satisfaction. If these are not met, as smooth as the care process may be regarded by the staff and personnel, then it does not align with the tenets of modern day care (Smith & Larew, 2013). Patient satisfaction is one of the aspects that have become core when determining outcomes. It is built on the need to develop a trust relationship with the patient that allows the patient to share their concerns, values, beliefs and perceptions on the care process as well as their expectations. This is what the synergy model seeks to achieve; to expand the issues along which the care plan and regimen can be tailored by developing closer relationships with the patient to identify their specific needs. Once these are identified, the care team which comprises of different personnel with diverse specialties will manage the patient within the identified needs specific to this patient. The synergy model therefore works in sync with the tenets of patient-centered care where the role of the patient is prioritized above that of the process itself as it is with interdisciplinary care delivery model (Kaplow & Reed, 2008).
References
Finkelman, A. W. (2012). Chapter 4 Organizational Structure for Effective Care Delivery. InLeadership and management for nurses: Core competencies for quality care (2nd ed., (pp. 120-127). Boston: Pearson.
Gathright, M. M., Holmes, K. J., Morris, E. M., & Gatlin, D. A. (2015). An Innovative, Interdisciplinary Model of Care for Inpatient Child Psychiatry: an Overview. The journal of behavioral health services & research, 1-13.
Kaplow, R., & Reed, K. D. (2008). The AACN synergy model for patient care: a nursing model as a force of magnetism. Nursing Economics, 26(1), 17.
Quintero, J. R. (2004). Developing an interdisciplinary model of care in a progressive medical care unit. Critical care nurse, 24(4), 65-72.
Smith, A. C., & Larew, C. (2013). Strengthening role clarity in acute care nurse case managers: application of the synergy model in staff development.Professional case management, 18(4), 190-198.
