Care Delivery System

A Nursing Care Delivery System defines the way we use our nursing values to care for our patients, families, colleagues, and selves.

The care delivery system is actually a subsystem of the professional practice model that describes our approach to delivering patient care by:

  1. Detailing assignments, responsibilities and authority to accomplish patient care;
  2. Determining who is going to perform what tasks, who is responsible, and who makes decisions; and
  3. Matching number and type of caregivers to patient care needs.

Relationship Based Care

Guided by our PPM, MUSC Nurses adopted Relationship Based Care (RBC) as our nursing care delivery system. 

Venn diagram showing the Relationship Based Care model

In RBC, the patient and family are always the central focus with an emphasis on the development of collaborative relationships needed to provide excellent patient care. There are three crucial relationships in RBC: 

  • Relationship with patients and their families. Care givers demonstrate unwavering respect for the patient and family and actively engage them in all aspects of care.
  • Relationship with colleagues. Care givers are committed to a common purpose and respect each colleagues’ unique contribution to the team.
  • Relationship with self. Care givers balance the demands of their role with their personal and professional health and well-being.

RBC is built on the tenet that the Registered Nurse has the authority, responsibility and accountability for the nursing process. How the RBC framework is implemented varies by setting but always reflects the PPM and core principles. The building blocks of the care delivery system in all settings include the following.

Nurse-Patient Relationship & Decision Making

  • RNs develop therapeutic caring relationships with patients and families/care givers.
  • The scope/duration of the nurse-patient relationship is defined by the needs of the patient and the care environment.
  • Decisions about care are made collaboratively with the patient or their representative based on the patient’s values, beliefs, and needs.
  • Nurses serve as patient advocates when the patient is not able or available to speak for themselves.

Work Allocation and/or Patient Assignments

  • RNs are involved in the planning and implementation of staffing plans that meet the needs of the patient/family.
  • Patient/nursing care assignments are based on the care environment, the needs of the patient and family, and staff competency.
  • While supporting continuity of care, work allocations and/or assignments may vary based on changing needs.

Communication Between Health Care Team Members

  • RNs actively participate in established processes for planning and evaluating interdisciplinary care.
  • RNs communicate directly with other members of the healthcare team, taking an active role in coordinating the patient’s care.
  • Formal and informal leaders serve as a resource to nursing staff and support the role of the RN in the coordination of patient care.

Management of the Unit or Environment of Care

  • Nursing staff are accountable for recognizing issues in the environment of care and actively working to resolve them.
  • Managers are accountable for seeking nursing staff input in decisions that impact the environment of care.
  • Formal and informal leaders serve as a resource to nursing staff and support the role of the RN in the coordination of patient care.