Redefining Nursing Care Models: What CNOs Need to Know to Stay Ahead
If you're a CNO, you’ve likely felt the growing pressure, the impossible staffing ratios, and the strain on care teams. A recent Wolters Kluwer survey of 157 nurse leaders confirms what many already know—traditional nursing care models are buckling under the weight of chronic staffing shortages and rising patient acuity. The old way of delivering care doesn't meet today’s demands. So, what’s next?
There’s no one-size-fits-all solution to fixing broken care models. While the Wolters Kluwer survey confirmed that approaches like values-based care (87%), collaborative care (81%), and team-based nursing (74%) work well in many settings, it also pointed to new directions CNOs found worth exploring.
5 Emerging Nursing Care Delivery Models
Several emerging models aim to improve nurses’ day-to-day experience and make patient care smoother and more efficient. According to the survey, here are the top five nursing care delivery models that healthcare organizations are planning to roll out next:
Home Health Nursing (71%)
Internal Float Pools (68%)
Virtual Nursing (66%)
Telehealth Nursing (66%)
Multi-disciplinary Care (61%)
5 Nursing Care Model Considerations
Rolling out new care delivery models isn’t just about meeting patient needs—it’s also an opportunity to tackle the root causes of nursing burnout and workforce shortages. So, when considering a new nursing care delivery model, CNOs need to weigh several key factors to ensure it drives real impact for their teams:
1. Workforce Sustainability
A care delivery model is only as strong as the workforce that powers it. Even the most innovative model will fail if nurses are stretched too thin, emotionally exhausted, or unsupported. When evaluating sustainability, CNOs should ask:
Does the model address workload balance? The model should help reduce the cognitive and physical load on bedside nurses by redistributing tasks across the care team or integrating support roles.
Will it create more predictable, flexible schedules? Models that promote flexible staffing, like float pools, per diem options, or self-scheduling, can improve work-life balance, which is a top priority for newer nurses.
Does it prioritize mental health and well-being? Models that build in time for breaks, emotional support, or access to wellness resources are more likely to retain staff long term.
Is it designed with nurse input? Involving nurses in model design increases buy-in and ensures the changes align with real-world needs.
Does it offer growth and development pathways? Sustainability also means giving nurses room to advance their careers through new roles in team-based models, leadership tracks, or opportunities to mentor others.
2. Operational Efficiency
For CNOs, operational efficiency isn’t just about cutting costs—it’s about creating smoother, smarter systems that allow nurses to focus on what matters most: patient care. A nursing care delivery model must eliminate friction in daily workflows and maximize the impact of every team member. When evaluating operational efficiency, consider the following:
Does it clearly define roles and responsibilities? Efficient models ensure that tasks are assigned to the right team members, preventing overlap and allowing nurses to operate at the top of their license.
Are there opportunities to integrate technology? Tools like EHRs, mobile communication platforms, clinical decision support systems, and virtual nursing can streamline documentation, enhance communication, and reduce time spent on manual or administrative tasks.
Does it reduce unnecessary steps in care delivery? Look for ways to simplify patient handoffs, medication administration, admissions, and discharge processes to save time and reduce errors.
Can resources be deployed more strategically? A well-designed model ensures that staff, equipment, and support services are aligned with patient acuity and census in real time, minimizing delays and maximizing throughput.
How does it impact care coordination? Team-based or collaborative models that improve communication between disciplines can reduce fragmentation and improve staff efficiency and patient outcomes.
3. Technology Integration
As care delivery evolves, technology is no longer a “nice-to-have”—it’s a core component of nursing operations. CNOs must evaluate a new nursing care model through the lens of IT alignment to ensure long-term viability and scalability. Here’s what to consider when it comes to technology integration:
Is your current infrastructure ready? Evaluate whether your existing IT systems—such as your EHR, communication platforms, scheduling software, and data analytics tools—can support the demands of the new model. If not, what upgrades are needed?
Does it support telehealth and virtual nursing? As virtual care grows, models incorporating remote triage, monitoring, or documentation roles can help alleviate pressure on in-person staff. But this only works if your systems support seamless, secure, real-time communication between virtual and bedside teams.
How does it impact the nurse user experience? Nurses need intuitive, user-friendly tools that simplify their work, not add to it. Poorly designed or fragmented systems lead to frustration and inefficiency. Look for platforms that integrate smoothly into daily workflows and minimize documentation burden.
Can it scale with evolving care needs? Choose flexible and adaptable technologies. For example, AI-powered decision support, smart staffing platforms, or wearable monitoring devices can evolve with patient needs and workforce changes.
Is there a plan for training and adoption? Even the best technology will fall flat without adequate training and support. Ensure there are onboarding plans, super-user support, and ongoing education to drive adoption and ensure ROI.
4. Financial Viability
For CNOs, every care delivery decision must balance clinical outcomes and financial sustainability. As labor costs continue to climb and reimbursement pressures increase, adopting a new nursing model isn’t just a clinical decision—it’s a strategic investment. Here’s what to evaluate when it comes to financial viability:
What’s the upfront investment—and the long-term return? Some models may require initial spending on technology, staffing shifts, or training programs. But if those investments lead to reduced turnover, improved retention, and fewer costly errors or readmissions, they can pay off significantly over time.
Does it reduce reliance on contract labor? One of the biggest drivers of workforce expenses is using travel nurses or agency staff. A sustainable model that boosts internal staffing and retention can reduce this dependency and stabilize your budget.
Can it optimize staffing ratios without compromising care? Efficient models allow you to better match staff to patient acuity, avoid overstaffing during slow periods, and quickly scale up when demand spikes, leading to better financial control.
Are there measurable savings from improved workflows? Streamlining documentation, reducing redundancies, and preventing burnout-related absences all translate into cost savings. Look for opportunities to measure ROI not just in dollars, but in time saved and productivity gained.
Does it align with value-based care incentives? Models that improve care quality, reduce complications, and enhance patient satisfaction can help organizations meet benchmarks tied to reimbursement under value-based care programs.
5. Scalability and Flexibility
Healthcare is anything but predictable, and nursing care models must be built to flex with that reality. For CNOs, scalability and flexibility aren’t optional features; they’re essential for maintaining quality care in the face of shifting demands. Here's what to consider when assessing a model’s adaptability:
Can the model flex up or down based on patient volume? Whether dealing with seasonal surges, pandemic spikes, or daily census changes, your model should allow for rapid staffing levels and care delivery adjustments without compromising safety or burning out staff.
Does it support varied acuity levels? As patient needs grow more complex, care models must ensure that high-acuity patients receive appropriate attention while still delivering efficient care to lower-acuity cases. This often requires tiered staffing structures or care teams with clearly defined roles.
Is it designed to work across care settings? A flexible model should be able to move seamlessly between inpatient, outpatient, home health, and virtual environments. This supports care continuity and allows the system to deploy resources where needed most.
How easily can it incorporate new roles or innovations? Whether integrating virtual nurses, advanced practice providers, or new technology like AI-based triage tools, CNOs should consider a model that can evolve without requiring a complete overhaul.
Can it support multiple scheduling needs? From full-time staff to float pools, per diem nurses, or job-sharing models, flexibility in how shifts are filled allows for more personalized staffing approaches and stronger retention.
Internal Float Pools Boost Coverage and Cut Costs
Choosing the right nursing care delivery model for your hospital or health system involves many considerations. But when it comes to internal float pool strategies, we can help you cut through the complexity by sharing what’s working for our healthcare partners.
UNC Health
Based in Chapel Hill, UNC Health operates a vast network of inpatient and outpatient facilities across all 100 counties in North Carolina. However, with low float pool participation, the system was experiencing coverage gaps that strained full-time staff and impacted care quality across 258 outpatient clinics.
To address the issue, UNC Health launched ShiftMed Flex in partnership with ShiftMed in November 2024. The platform gives float nurses 24/7 visibility into open shifts, allowing them to take control of their schedules and work when and where they choose.
Within three months, float nurse engagement soared—monthly shift commitments doubled from four to eight, significantly increasing shift coverage and easing pressure on core staff.
SSM Health
SSM Health operates the largest float pool in the nation with the help of ShiftMed. Like many healthcare organizations, SSM Health leaned heavily on high-cost contingent labor during the pandemic, including 1099 contractors, which created financial and legal challenges in the post-pandemic landscape.
To tackle these issues, SSM Health partnered with ShiftMed in July 2023 to tap into a reliable pool of local W-2 nurses on demand, and the results have been significant. For example, 854 ShiftMed nurses are picking up more than nine shifts each month, and over 500 have seamlessly transitioned into full-time roles at SSM Health—without the organization incurring any buyout fees.
Today, credentialed RNs, LPNs, CNAs, and respiratory therapists from the ShiftMed float pool support a wide range of units—including critical care, med-surg, behavioral health, emergency departments, and even post-acute settings.
SSM Health treats these on-demand professionals as an extension of its regional float pools, seamlessly reallocating them across ministries based on real-time staffing needs.
Rethinking Nurse Care Delivery for a Sustainable Future
The landscape of nursing is evolving fast, and traditional care delivery models simply can’t keep up. As CNOs face unprecedented pressure from staffing shortages, rising acuity, and shifting workforce expectations, now is the time to reimagine how care is delivered.
The good news? You don’t have to start from scratch. By learning from peers and piloting proven strategies—like internal float pools supported by on-demand technology—you can build models that are clinically effective, financially sustainable, technologically integrated, and responsive to the needs of today’s nurses.
ShiftMed’s partnerships with forward-thinking organizations like UNC Health and SSM Health show what’s possible when innovation meets execution. Whether your goal is to reduce burnout, boost shift coverage, or scale care across settings, the right care model can unlock flexibility, resilience, and a healthier workforce.
The future of nursing depends on bold leadership. Your decisions today will define care delivery for years to come.
Schedule your free workforce consultation with ShiftMed today and discover how we can help you design a nursing care delivery model that meets your unique needs.