Creating a 24/7 Model for Patient–Family-Centered Care

A major challenge for hospitals is ensuring consistent and standardized patient care across all shifts. In particular, evenings and nights are of concern because most patients are admitted to hospitals during those hours. In 2009, Yale-New Haven Hospital (Y-NHH), a 948-licensed-bed university teaching organization, embarked on a journey to establish a 24/7 leadership model to enhance the culture of safety, provide seamless care delivery, and comply with performance standards. Although care delivery was multidisciplinary and provided a full range of services and coverage from 7 a.m. to 3 p.m., after those prime hours, many departments, nursing included, scaled back resources. Thus, full clinical and managerial coverage was in fact only available one-third of the time, whereas two-thirds of the time, patients and staff were working with fewer resources while caring for the same volume and acuity of patient populations.