The heart of the 12-Bed Hospital model is new role of Patient Care Facilitator (PCF), an RN who serves as a “clinical CEO” for a specific 12 to 16-bed unit. The PCF assumes 24-7 accountability for the management of her or his unit and manages the care of each patient on that unit from admission to discharge.
The PCFs serve as the primary contact for physicians, social workers and other members of the interdisciplinary team. The PCF is the primary liaison with patients and families, actively engaging them in the care plan. Each PCF’s picture and business card are prominently displayed in the patient rooms of her or his 12-Bed Hospital.
Each PCF typically works with a team of two RNs and two clinical health partners (patient care technicians), and the team stays with the same PCF to promote teamwork and shared knowledge.
The PCF plays an important role in training, mentoring, and supporting novice nurses. The PCF is readily accessible to new nurses and can provide assistance with anything from patient care to learning the hospital system and procedures. In addition, each PCF is responsible for mentoring other nursing team members (RNs and patient care technicians) in her or his 12-Bed Hospital. Part of the PCF job is to help with patient care so it encourages nurses (both novice and experienced) to ask for assistance and learn.
Patient Care Facilitators are specialty-certified, BSN-prepared RNs with at least 3 years of experience.
Each PCF’s performance is monitored weekly via a dashboard of quality core measures, length of stay, throughput (as measured by percent of patients discharged by target times), and patient satisfaction score. The report includes goals and monthly performance in each of those areas, as well as an action plan of specific steps to improve performance in each area. The report also includes a personal and clinical development plan for the PCF.
Since the successful implementation of the model, Baptist has added the new role of Advanced PCF, which helps provide additional support to the model as well as a career ladder for individuals assuming PCF positions. Of the 40+ patient care facilitators on staff at Baptist, 50 percent are Advanced PCFs: Nurse Practitioners, Clinical Nurse Specialists and Clinical Nurse Leaders with advanced nursing degrees.
The Advanced PCF works closely with the management team in planning clinical goals and objectives for a patient unit and serves as a leader for organizational initiatives. In addition, the Advanced PCF is responsible for data collection and analysis within service-line performance improvement teams.
The PCFs meet monthly in a council meeting on their own to discuss how they are going to manage and own their own professional practice. (Baptist was the first hospital in Florida to receive Magnet designation, and they have a shared governance structure for nurses.) The council elects its own officers, adopts its own bylaws, and runs its own meetings. The council provides an important venue for PCFs to learn from each other and to continually grow their role to serve the needs of their patients.
