Patient participation in health care: an underused resource.

The CCM has been in development for more than 3 years and in operation for more than 2 years. According to Peters, "Developing a vision is a messy, artistic process. Living it convincingly is a passionate one beyond any doubt." This statement expresses our personal experience in development of the CCM in terms of time, effort, hurdles, growth, and satisfaction. An environment has been created that strengthens the nurse's role as clinical educator, advocate, and coordinator. Capable patients and families on pilot units express satisfaction because they have learned to participate actively in their care during hospitalization, to better understand their disease, and to better manage their care at home. The time saved for nurses allows them to be engaged in activities of health promotion and education, deliver selected aspects of care, and consult with other team members on issues of problematic patient management. In this environment, professional nursing practice has been enhanced and nurses are influencing positive patient outcomes. In addition, our nurse recruiter reports that it is easier to recruit nurses for CCM pilot units than for nonpilot units with similar patient populations. This project has tapped an often underused resource, the patient's self-care ability, and created an environment that benefits not only the care recipients but also the caregivers.