In its deliberations on the shortage of nurses, the Executive Board of NAON charged the Orthopaedic Nursing journal with bringing information to our readers concerning innovations in nursing care which have resulted partly in response to the current nursing crisis. This article presents an innovative care model implemented on an orthopaedic unit at Robert Wood Johnson University Hospital in New Brunswick, New Jersey. It describes not only the developed system but also the process that was used in implementing the design.