Relationship Based Care
A Caring and Healing Environment according to Patients and Families
Research shows that patients and families define caring and healing environments as those in which they are actively involved in their own care--where they feel as though they are seen as whole people (body, mind and spirit), and where they have established an individualized relationship with physicians, nurses, and other care providers.
What is a Professional Practice Model?
A Professional Practice Model (PPM) is a system that supports healthcare provider decision-making about the delivery of care and the environment in which care is delivered.
What is Relationship-Based Care (RBC)?
RBC is the new professional practice model at North Carolina Baptist Hospital. "RBC is a model to guide practitioners in transforming care delivery from the inside out." - Jean Watson, PhD, RN, FAAN
The RBC model is comprised of 3 crucial relationships:
· Care provider's relationships with patients and families.
o The care provider knows that each person's unique life story determines how he/she will experience illness.
· Care provider's relationships with self.
o The relationship is nurtured by self-knowing, and self-care.
· Care provider's relationships with colleagues.
o Quality care occurs in environments where the standard among members of the health care team is to respect and affirm each other's unique scope of practice and contribution, to work interdependently to achieve a common purpose, and to accept responsibility for creating a culture of learning, mutual support, and creative problem-solving.
Why RBC?
- RBC is patient/family centered.
- RBC fits well with our organizational and nursing mission, vision, and values.
- The Core business of healthcare is caring and healing of patients.
How is RBC provided?
The essence of care is experienced in the moment when one person connects to another. Compassion and care can be conveyed through a touch, kind act, competent clinical interventions, or listening and seeking to understand the other's experience. This is the heart of Relationship-Based Care.
Responsibility + Authority + Accountability (R+A+A)
Responsibility refers to the clear and specific allocation of duties in order to achieve desired results. Assignment of responsibility is a two way process. Responsibility is visibly given and visibly accepted.
Authority is the right to act and make decisions in the areas where one is given and accepts responsibility.
Accountability begins when one reviews and reflects upon his own actions and decisions, and culminates with a personal assessment that helps the accountable person discern how to proceed in the future.
The new shared governance structure at NCBH has moved many aspects of Responsibility + Authority + Accountability (R+A+A) closer to the bedside. Now many decisions related to practice are the responsibility of staff members. This is an ideal environment for implementation of a relationship-based care environment. When decisions related to how care is given are made by those closest to the point of care more realistic and patient-centered care is realized.
What RBC is not?
It is not a staffing model; and not a cookie cutter concept. RBC has core principles, but the guidelines of how they will be implemented will be different, based on decisions made during implementation.
Implementation
RBC is being rolled out to departments with support from nursing professional practice.
Many decisions will be made by Unit Based Shared Governance to determine the guidelines for their units within the principles of the Professional Practice Model.
"True healers provide the space for patients to heal themselves. We provide that space by embodying caring as individuals; we provide that space in behaviors that demonstrate caring; we provide that space by our deliberate creation of a physical environment that promotes healing; and we provide that space by creating care delivery systems that support and promote relationships. Relationship-Based Care challenges all of us to practice healing every day." - Mary Koloroutis, RN, MS
For more information please contact:
Judy B. McDowell, Professional Practice Manager
Randy L. Williams, Professional Practice Coordinator