Nontraditional models of care delivery: have they solved the problems?

Healthcare delivery systems in the United States are changing rapidly in response to socioeconomic forces. In the new competitive healthcare market, work has been redesigned, with hospitals changing their skill mix to include unlicensed assisitive personnel. Having previously described the more traditional models of care delivery, (JONA, June 2004), the authors will now discuss a variety of nontraditional practice models that have been developed to address the changing needs of healthcare. These models and their driving forces are described. Indicators of success, including quality, cost, and satisfaction, are also examined.