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Overview of Patient Care Delivery System:

Total Patient Care

Healthcare Delivery Systems

Improvement Project

Nurses assume total responsibility for their patients

during their time on duty. All patient needs are thus
directed towards the assigned nurse for the duration of
their shift.

Marlee Feinholz
Katherine Yeh
Kaitlyn Parks
Mary Sepulveda
Devyn Weber

Impact on the Delivery of Care

Patient receives holistic and unfragmented care
during the nurses time on duty
Shift change/different nurses can result in different
approaches to patient care
Requires highly skilled personnel, causing a
disadvantage when the nurse is inadequately
prepared to provide complete patient care

December 2, 2015

(Marquis & Huston, 2009)

Microsystem Model:
Quantum Leadership

Microsystem Mode:
Organizational Culture and Support

Managers must work together with their employees to

have common goals, exploit opportunities, and empower
staff to make decisions that promote organizational

Banner University Medical Center


Assessing the Organizational Culture

Impact on Delivery of Care

Physical Environment
Social Environment
Organizational Support
Organizations Power Structure
Organization Safety
Organization Taboos

Plays a primary role in situations of rapid change and

needed transition (UAMC Banner UMC)
Improves the units organizational productivity, which
stems into the delivery of care
Impacts the innovative set of interactions and
relationships in the Trauma ICU, easing adaption to the
fluid, flexible, and mobile environment
(Marquis & Huston, 2009)

(Banner Health, 2015)

(Marquis & Huston, 2009)

Microsystem Model:
Interdependence of Care Team

Microsystem Model:
Patient Focus & Staff Focus
Banner University Medical Center: Teaching Hospital
A hospital closely associated with a medical school,
serving as a practical educational site for medical
students, interns, residents, and allied health personnel.
Evidence-Based Practice
Continual Research
Health Care Workers
Patient Focused and Centered
Round the Clock Physician Care
(Banner Health, 2015)

Banner-UMCs Trauma ICU takes a multidisciplinary

team leader approach.
Incorporates pharmacists, social workers,
occupational therapists, speech therapists, and other
health care workers as part of a multidisciplinary team
to assure that comprehensive and holistic health care
can be provided to each patient

Impact on Care
Requires Efficient Communication
Requires Whole Team Meeting
Reduced Patient Mortality & Improved Quality of Life
(Marquis & Huston, 2009)


Microsystem Model:
Use of Information and Healthcare Technology

Microsystem Model:
Process for Healthcare Delivery Improvement

Technology has given us the potential for instant

information access and exchange
Banner-UMC Trauma ICU utilizes and accepts
technology as an adjunct to their nursing cognizance.

Microsystems improve many aspects of clinical

Process improvement in the Trauma ICU:
Successful Process Improvement program:
Event identification
Corrective action plans
Methods of monitoring
Achieving problem resolution

Impact on Care
Internet for communication and information
Hospital Information System and Intranet
Social Media and Organizational Communication

(Marquis & Huston, 2009)

Microsystem Model:
Staff Performance Patterns

(Center for Health-System Pharmacy Development, 2011) (Pidgeon, 2015)

Specific Aspect Targeted for Improvement

The culture of Trauma ICU: The demands of this
specialty can lead to frustration, burnout, tension in the
workplace, and increased job dissatisfaction.

Performance Evaluation in the Trauma ICU

Staff performance evaluation form
Needs Improvement, Meets or Exceeds
Annual meeting with unit manager to review
Education and remediation in areas that need
improvement or correction

How to improve this culture Culture of Mentorship,

which is conducive to fostering growth
Maximizes a nurses career potential
Enhance career development
Prepare the nurse for potential leadership roles

(S.J., personal communication, November 19, 2015)

A culture that fosters mentorship produces:

Improved job satisfaction
Promotes professional development and empowerment

amongst staff
Results in high quality healthcare
Improved patient outcomes

of an effective mentoring program:

Safer and more competent nursing practice

(Race & Skees, 2010)


Leading the Plan for Healthcare Delivery


Specific Aspect Targeted for Improvement



(Race & Skees, 2010)


Key Elements to Sustain a Mentoring Program

A stable infrastructure
Managerial and executive support
Schedule flexibility
Strategies for Successful Role Transition & Professional
The National League for Nursing Tool Kit
Mentorship facilitator/coordinator
Collegial mentoring model
Formal vs. informal mentoring program
Learning needs assessments
Careful mentoring
(Race & Skees, 2010)
Reward mechanisms




Banner Health. (2014). Banner code of conduct. Retrieved


Center for Health-System Pharmacy Development. (2011).

Understanding high performing clinical microsystems.
Retrieved from

Banner Health. (2015). Our nonprofit mission. Retrieved


Marquis, B.L., & Huston, C.J. (2009). Leadership roles and

management functions in nursing: Theory and application.
(8th ed.). Philadelphia, PA: Wolters Kluwer Health/
Lippincott Williams & Wilkins.


Pidgeon, K. (2015). The genesis of a trauma performance

improvement plan. Journal of Trauma Nursing, 22(6),
315-320. doi:10.1097/JTN.0000000000000166