In a recent Lippincott® Solutions sponsored CNO roundtable, nurse leaders discussed how changes to care delivery models are being implemented across care settings, what’s working, what’s falling short, and what is needed so they are sustainable.
The rapid evolution of nursing care delivery models has become one of the most pressing operational priorities facing nurse leaders today. To explore how health systems are navigating workforce instability, virtual nursing, workforce redesign, and operational sustainability, Lippincott convened a recent CNO roundtable discussion with nurse leaders from across the country.
Responding to the need for radical change in nursing care models
What emerged from the conversation was a clear shift in focus as compared to just a year ago. Rather than pursuing large-scale care delivery transformation initiatives, many organizations are now concentrating on how to operationalize, stabilize, and sustain care delivery models within the realities of day-to-day clinical practice. Leaders repeatedly emphasized that success is no longer defined by launching new models alone, but by whether those models improve nursing workflows, support frontline teams, and hold up under ongoing staffing and financial pressure.
The discussion reinforced several themes also reflected in the most recent Lippincott® FutureCare Nursing Survey.
- Nurse leaders are shifting from large-scale care model redesign to operational refinement and sustainability.
- Team-based care and virtual nursing remain important strategies, but success depends heavily on workflow integration (adequate change management) and staff satisfaction.
- Workforce development is becoming a strategic operational priority as organizations build internal pipelines, expand role flexibility, and redesign teams around evolving care delivery demands.
Participants also described how the role of nursing leadership itself continues to expand. In addition to overseeing bedside care, many nurse leaders now carry operational, financial, workforce, and technology responsibilities that increasingly shape organizational performance. Several leaders noted growing concern that other departments continue to try shifting operational burdens toward nursing teams, though leaders resisted taking on this work without corresponding FTE allocation to nursing.
As organizations continue modernizing care delivery, nurse leaders are asking a more practical question: Which strategies actually work in practice — and under what conditions?
Which nursing care delivery models are working in practice?
One of the clearest themes from the roundtable was that no single care delivery model emerged as universally effective. Instead, leaders consistently emphasized that outcomes depended on how well new approaches were operationalized within existing workflows, staffing realities, and unit culture.
Team-based and multidisciplinary care
Many organizations continue to report strong results from team-based and multidisciplinary care models. Leaders described these approaches as essential for helping distribute workload demands more effectively across clinical teams. However, participants also noted that success depends heavily on thoughtful integration into existing staffing structures and operational processes rather than simply introducing new roles or terminology.
Virtual nursing generated similar discussion
While many organizations view virtual nursing as an important long-term workforce strategy, participants reported mixed outcomes tied to implementation approaches. Hospitals that introduced virtual nursing gradually and connected the model to clearly defined workflows often reported stronger adoption and operational value. In contrast, broader enterprise-wide deployments frequently struggled because workflows differed significantly across facilities and care settings.
Several leaders described successful use cases centered on discharge support, patient education, and family communication. Others emphasized that virtual nursing works best when integrated into hybrid care delivery models that support bedside teams rather than functioning as a standalone technology initiative.
The reintegration of Licensed Practical Nurses (LPNs)
Participants also discussed the growing reintegration of LPNs and Licensed Vocational Nurses (LVNs) into acute care settings. Many organizations are aggressively recruiting these roles to help extend RN capacity and stabilize staffing. Yet leaders acknowledged that results remain inconsistent. In some emergency department and acute care environments, LPN integration improved flexibility and workload distribution. In others, challenges emerged around delegation workflows, role clarity, and staff trust.
The discussion also highlighted unintended consequences across the broader care continuum. Aggressive hospital recruitment of LPNs is contributing to additional shortages in long-term care and post-acute environments that are already facing turnover and staffing instability.
What emerged from the conversation was a growing insistence that new models demonstrate operational value inside real clinical environments. Nurse leaders are increasingly focused on refining care delivery approaches based on measurable workflow improvement, staff acceptance, and sustainability.