Jupiter Medical Center’s Care Delivery System: Relationship Based Care, Total Patient Care

Description of the JMC Care Delivery System

Our Care Delivery System at Jupiter Medical Center is Relationship Based Care. In Relationship Based Care, the total patient is considered in the delivery of care.  This Care Delivery System emphasizes the development of collaborative relationships as a foundation to provide excellent patient care.  Relationship Based Care is comprised of three crucial relationships

  • Relationships with patients and their families
  • Relationships with colleagues
  • Relationship with self

Within this framework of Relationship Based Care/ Total Patient Care, the Registered Nurse has the authority, responsibility and accountability for assessing, diagnosing, planning, implementing and evaluating the patient’s nursing care.  In this system, the nurse patient relationship is always safeguarded, but the professional nurse may delegate nursing activities to other care providers.

Within the framework of Relationship Based Care the Registered Nurse practices total patient care. The Elements of Total Patient Care include:

  • Nurse patient relationship and Decision Making:
    Decision making occurs over a single shift either by an RN caring for the patient or a charge nurse.
  • Work allocation and or/ patient assignments:
    Nursing assignments are largely patient based with RN providing activities of care. Nursing assignments may vary by shift based on geography and patient acuity while supporting continuity of care
  • Communication between health care team members:
    Communication is direct.   RN’s may be required to communicate with physicians and other members of the health care team through a charge nurse  or by direct communicate.
  • Management of the unit or environment of care:
    Managers serve as a resource and promote nurses having a stronger role in care decisions.

Frameworks for the Delivery of Patient Care

In recognition of the unique characteristics of patients and their needs, each clinical unit that provides nursing care has an established Framework for the Delivery of Patient Care. Included in this Framework is unit/patient specific data on:

  • Description of the unit
  • Populations served/patient characteristics
  • Age,  ethnic,  cultural and spiritual patient characteristics
  • Scope and complexity of patients
  • Admission characteristics
  • Assessment/reassessment practices and standards
  • Staffing ratios
  • Standards for assignment of patients
  • Required competencies of the unit staff to meet patient needs
  • The Relationship Based Care/Total Patient Care Delivery Model
  • Internal Experts and External Consultants that support care delivery
  • Standards to assure continuity of Care
  • Professional nursing standards that guide care delivery
  • Performance improvement indicators to measure the effectiveness and efficiency of the care delivery system for the unit

Evaluation of the Professional Practice Model and Care Delivery System(s)

Our Professional Practice Model and Care Delivery Models will be evaluated and revised based on new evidence and or research and on outcome data to include:

  • The Joint Commission standards and National Patient Safety Goals
  • Patient Satisfaction survey results
  • NDNQI nursing sensitive indicator outcomes
  • Surgical Care Improvement Program outcome data (SCIP)
  • Unit Scorecards
  • The NDNQI Staff RN Satisfaction Survey
  • CMS Core Measures
  • Unit based surveys 

The evaluation of the Professional Practice Model and Care Delivery System is integrated within the nursing performance program.