Clinical Nurse Leader-Integrated Care Delivery: An Approach to Organizing Nursing Knowledge Into Practice Models That Promote Interprofessional, Team-Based Care.

Abstract

J Nurs Care Qual Vol. 32, No. 3, pp. 189–195 c 2017 Wolters Kluwer Health, Inc. All rights reserved. Copyright Commentary In this commentary, a clinical nurse leader (CNL) reflects on the role of the CNL in promoting continuity of care. Clinical Nurse Leader–Integrated Care Delivery An Approach to Organizing Nursing Knowledge Into Practice Models That Promote Interprofessional, Team-Based Care Miriam Bender, PhD, RN, CNL T HE STORY told by Segal 1 in “Looking for Continuity of Care” is unfortunately typical for many patients and families work- ing their way through today’s health care system. The problem expressed so articu- lately by Segal is a distinct lack of the critical health care communication and collaboration practices that drive continuity of care. This state of affairs continues despite the fact that we have an extensive literature defining what care quality should look like in terms of patient-centeredness, timeliness, safety, Author Affiliation: Sue and Bill Gross School of Nursing, University of California, Irvine. The author declares no conflict of interest. Correspondence: Miriam Bender, PhD, RN, CNL, Sue and Bill Gross School of Nursing, University of Cal- ifornia, Irvine, 252C Berk Hall, Irvine, CA 92697 (miriamb@uci.edu). Accepted for publication: January 10, 2017 Published ahead of print: February 16, 2017 DOI: 10.1097/NCQ.0000000000000247 efficiency, effectiveness, and equity. 2 One issue is current care delivery infrastructures, which actively hinder interprofessional collaborative care processes. 3,4 As Segal’s experience exemplified so acutely, the majority of today’s care environments are structured so that nurses, physicians, other care providers, and administrative managers and leaders deliver or ensure quality care via mutually exclusive processes, with unique expected outcomes that are informed by distinct disciplinary curricula and training. Researchers and health care leaders are ac- tively seeking ways to redesign care systems in ways that overcome these critical chal- lenges. The purposes of this article are to (a) describe current conceptualizations of in- terprofessional communication and collabo- ration; (b) summarize the literature on clin- ical leadership, a mode of clinical behavior to promote engagement in specific practices; and (c) delineate current theory and evidence about clinical nurse leader (CNL)–integrated care delivery, an approach to structuring Copyright © 2017 Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited.