Innovative Nursing Care Model: Living Independently for Elders (LIFE)
I chose the Living Independently for Elders (LIFE) model on the basis that it targets the heavy users of health care, the older adults transitioning from hospitals to homes, or those eligible for admission into nursing homes. Through this model, an organization can build health care services, which include provider networks, care plans, and technology to consolidate limited health care resources around the complex needs of older adults while ensuring that they are not deprived of the much-needed supportive care and love from their families (Health Workforce Solutions [HWS], 2008). This model is in line with the Penn Nursing Network’s mission statement, which is “Excellence in healthcare practice, education, and research”. Here, the organization maintains that while it is possible that most families are unable to meet the needs of their elderly members around the clock, it is possible for care delivery systems to provide chronic care needs in the community. Therefore, the LIFE program is modeled to meet the primary, preventive, acute, and long-term care services among older clients while assuring them and other family members of their independence, choice, and dignity (HWS, 2008).
Development Team for Innovative Nursing Care Model
The LIFE program is centered on an interdisciplinary team, which is charged with the responsibility of implementing the key components of the model in an organization. Therefore, the interdisciplinary team consists of Certified Nurse Practitioners, RN/LPNs, Physicians, Physical and Occupational Therapists, Creative Art Therapists, Recreational Therapists, Registered Dieticians, Van Drivers, and nurses Aids. These team members are important to the success of the LIFE program considering that it aims at meeting a wide range of health care needs including primary, preventive, acute, and long-term care. Most importantly, since the LIFE program is a community-based model, the interdisciplinary team should include church administrators (Chaplains) and Social Workers who will liaise with the primary care providers listed above to ensure that the target population receives the intended services (HWS, 2008).
Incorporation of Selected Model into My Work Setting
The LIFE program is modeled in line with various components of the Program of All-Inclusive Care for the Elderly (PACE). Therefore, an integrated PACE model of care for a LIFE-based program consists of an interdisciplinary team at the center. At the periphery of the program, there are various health care services provided by the central team, which include primary care & pharmacy services, day health care center & social services, in-home services, acute hospital care, skilled nursing facility care, specialty (behavioral health, podiatry, and dentistry) care, rehabilitative & activity services, and transportation services (Sullivan-Marx, 2009). To incorporate the various components of the LIFE program into my work setting, it is imperative to understand the model and its service requirements before assessing the target community’s needs & capacity, planning and developing the provider application, building a census around the program’s operations, and developing a financial plan. Most importantly, there is the need for curriculum development to guide the training of health professionals in the interdisciplinary team to overcome the challenges of strained resources, dispersed populations, and limited access to care services (National PACE Association, 2002).
Implementation and Evaluation
With the interdisciplinary team in place, the development and implementation of the LIFE program usually take about 12-24 months. This includes evaluating the community need for the LIFE program, developing a financial plan to help with funding, and completing an application. Conventionally, program implementation follows through discussions with state representatives, market analysis and feasibility studies, site selection and design, development of provider networks, community education, and finally, application development and assessment by state and federal agencies (HWS, 2008). Conversely, the success of the LIFE program will be based on the continuous tracking of program results relative to various outcomes such as patient/client satisfaction, nurse retention, and hospital readmissions, which should be measured against comparable but different programs such as home- and community-based services (HCBS). If necessary, mid-course corrections should be initiated to ensure that the desired goals are met (Mancuso, Yamashiro, & Felver, 2005, p. 1).
HWS. Health Workforce Solutions. (2008). Living Independently for Elders. Princeton, NJ: Robert Wood Johnson Foundation.
Mancuso, D., Yamashiro, G., & Felver, B. (2005). The Program of All-Inclusive Care for the Elderly (PACE): An evaluation. Washington: State Department of Social and Health services & Data Analysis Division.
National PACE Association. (2002). Developing PACE. Alexandria, Virginia: National PACE Association.
Sullivan-Marx, E.M. (2009). Penn nursing’s LIFE Program: Integrating Practice and Scholarship in the community. Pennsylvania: University of Pennsylvania, School of Nursing.