Domain III is the Care Delivery System. The Care Delivery System is a “system for the provision of care that delineates the nurse’s authority and accountability for clinical decision-making and outcomes” (ANCC). Integrated throughout the Nursing Professional Practice Model, it is adapted to regulatory considerations and describes the context of care, the manner in which care is delivered, skill set required, and expected outcomes of care. Being a professional nurse also means more than doing tasks. We need to differentiate between performing tasks and practicing nursing. As nurses, we place patients in the best position to heal.
The Green color symbolizes safety, growth, hope, harmony, and healing.
The three components in the Care Delivery System Domain promote continuous, consistent, efficient, and accountable nursing care: 1) Nursing Practice, 2) Information Systems, and 3) Quality Management.
Nursing PracticeNursing practice is what we do every day we come to work – what every direct care nurse will probably relate to the most. This component involves clinical decision making, how work is allocated, how we communicate with patients and other professionals, and how we manage our nursing care. Our nursing practice is evidence-based and patient-centered.
Information Systems include the management and decision support processes integrated within the electronic health record (EHR). It is basically what we do every day--which is chart in Epic. These clinical documentation applications provide the information base and structure for nurses to deliver evidence-based and patient-centered care, as well as communicate with others on the healthcare team.
These processes enhance nursing care delivery by:
Quality ManagementQuality Management lays the foundation for an effective care delivery system. Managing quality (and safety) facilitates systems that provide:
At Harris Health, we practice the PDCA model for improvement, which is a cycle of high-quality care: 1) develop standards, 2) put them into practice, 3) evaluate outcomes and benchmarks, and 4) validate performance and/or make plans for improvement. If improvement is not demonstrated, the cycle starts again.