Care Delivery Models in Acute Care Hospitals

OBJECTIVE The aims of this study were to identify care delivery models (CDMs) currently used in acute care settings and explore sources of variability at the unit, hospital, and system levels. BACKGROUND Despite efforts to improve healthcare delivery, acute care settings continue to face challenges such as workforce shortages, inefficiencies, and inconsistent patient outcomes. Care delivery models define how care is organized and delivered, yet current research on CDM innovation is sparse. METHODS A multimethod design was used, including a survey of 294 nurse leaders and 34 qualitative interviews. Logistic regression and content analysis identified factors influencing CDM changes. RESULTS Primary nursing was the most common CDM (61.6%). Care delivery model changes were driven by staffing shortages, hospital size, and leadership position. A typology of unit-, hospital-, and system-level drivers emerged. CONCLUSIONS Care delivery model changes are often reactive rather than strategic or evidence based. Understanding organizational drivers and having aligned metrics can aid in more intentional implementation and evaluation of CDMs.