Models of Practice

Model Characteristics for theRelationship-based Care ModelApplication to Your Advanced Practice Role
Characteristic 1: Relationship-based care is a timely and relevant model for the current diverse healthcare delivery system and focuses on the essential relationship the provider has with patients and families. Evidence indicates that patient engagement strategies improve care delivery and translate into better outcomes in relation to patient satisfaction (Guglielmi, Stratton, & Healy, 2014). The nursing professionals play a critically significant role in patient engagement in the delivery of quality and safe care to meet the needs of the patients. Applied to the advanced practice nurse role, the relationship-based care model will help in setting the groundwork for patient-centered care as an important element in the delivery of quality and safe patient care. The goal of healthcare providers is to meet the needs of patients and those of their family members. However, this cannot be achieved without fully engaging the patients and their families in their care. As an APN, the relationship-based care model will help me inform the patients about their rights, provide them with information that will help them make the right decisions regarding their health, and support the patients in their decisions. 
Characteristics 2: promotes healthy relationships among team members.Relationship-based care is a model, which is not only centered on the patient and the family but also focuses on promoting the healthy relationship among team members. According to Hebda and Patton (2012), the goal of most healthcare settings is to provide care that is built on relationships and partnership with healthcare providers. Consistent with the APN role, the model will help in forming relationships with other care providers for the delivery and quality and safe patient care. The APN will be able to collaborate with all the healthcare personnel involved in the delivery of care to ensure that they meet all the patient’s needs. 
Characteristic 3: The relationship-centered care focuses on enhancing the relationship with selfHealthcare is becoming more specialized and complex, demanding a nuanced approach to understand the individual interaction with the system to improve delivery of patient care. According to Soklaridis, Ravitz, and Adler (2016), the way care is delivered by the providers is dependent on several factors. Beyond patient-based care, relationship-centered care focuses on the way relationships influence the outcome of care delivery among patients. Arguably, as Hebda and Patton (2012) noted, relationship with self is an important factor in today’s diverse healthcare delivery system. Consequently, having a relationship with self is important because it allows the individual to look within the unconscious and enter into a dialogue with their deepest self (Soklaridis, et al.). This is an approach to therapy and personal change and helps the individual reconnect the mind and the body processes. The importance of self-reflection in APN practice cannot be understated and can be used on various levels. For instance,  having a relationship with self can be used to reflect on specific incidents, actions, thoughts, and feelings associated with the context, which can be used to better understand the patient requirements. Relationship with self can also be used to recognize new skills and articulate new approaches to a particular problem in the delivery of care. 
Characteristic 4: the paradigm of relationship-centered care also extends beyond the patient to the community. Ideally, relationship-based care is not only focused on the patient, it extends to the whole care team, the entire healthcare delivery system, as well as the community (Nundy & Oswald, 2014). In this case, the community includes the family, the peer-patient support group, and the community healthcare resources. It recognizes that, while the relationship of the care provider with the community might be broad, it is extremely important. Caregivers can offer various types of support to the patient when they form a relationship with the community. Relating to the advanced nurse practice role, forming a relationship with the community will help in recommending the patients to some of the community health resources and even help with disease control and prevention. 
Characteristic 5: relationship-centered care recognizes the importance and the uniqueness of each participant’s relationship and considers the relationships to be important in supporting high-quality care.In the past two decades, healthcare delivery system has shifted to a patient-centered care that is more focused on meeting the needs of the patients. The unique proposition of the relationship-centered care is that stresses it the importance of relationships. The model offers a set of values and approaches, with a central theme – that relationships are critical to good care (Suchman, 2006). Consequently, and according to Safran, Miller, and Beckman (2006), each of the four relationships is important in the delivery of care. Each one of them is unique and contribute to the delivery of quality care and improved patient outcomes. Understanding that the four relationships are important and relating to the advanced practice nurse role, I understand the importance of maintaining the relationships and recognizing their contribution. I also understand that it is not possible to do away with one of them, instead, it is important to ensure their continuity. 

References

Guglielmi, C. L., Stratton, M., Healy, G. B., Shapiro, D., Duffy, W. J., Dean, B. L., & Groah, L. K. (2014). The Growing Role of Patient Engagement: Relationship-based Care in a Changing Health Care System. Aorn Journal, 99(4), 517-528.

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Hebda, T.,& Patton, C. (2012). Application of the Relationship-Based Care Model to Improve Health Outcomes via the Electronic Personal Health Record. Creative Nursing, 18(1), 30-33.

Nundy, S., & Oswald, J. (2014). Relationship-centered care: A new paradigm for population health management. Healthcare, 2(4), 216-219.

Safran, D. G., Miller, W., Beckman, H. (2006). Organizational Dimensions of Relationship-Centered Care. Journal of General Internal Medicine, 21, s9 – s15. 

Soklaridis, S., Ravitz, P., Adler, G., & Lieff, S. (2016). Relationship-centered care in health: A 20-year scoping review. Patient Experience Journal, 3(1), 130-145.Suchman, A. L. (2006). A new theoretical foundation for relationship-centered care: Complex responsive processes of relating. Journal of General Internal Medicine, 21(1), 40-44.

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