OPT model and the CCCR model

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Understanding Patient Needs: OPT and CCCR Models in Action

Nurses play a crucial role in patient care, not just by administering treatments but also by understanding the unique needs and circumstances of each patient and their family. Two frameworks, the Outcome-Present State-Test (OPT) model and the Care Coordination Clinical Reasoning (CCCR) model, guide nurses in providing patient-centered care.

OPT Model: Focusing on Desired Outcomes

The OPT model, developed by Carolyn Pendergrass, emphasizes goal-oriented care (Tyo et al., 2019). It follows a three-step approach:

1. Outcome: Identify the desired outcome of care in collaboration with the patient and family. This could be regaining physical function after surgery, managing chronic illness effectively, or achieving emotional well-being.
2. Present State: Assess the patient's current state, considering their physical, emotional, and social factors. This includes their medical history, current symptoms, family support system, and any limitations they might face.
3. Test: Develop interventions (tests) to bridge the gap between the desired outcome and the present state. These interventions can be medications, therapies, educational sessions, or referrals to other healthcare professionals.

Example of OPT in Action:

Imagine a patient recovering from a hip replacement surgery. The desired outcome is for the patient to regain mobility and return home safely. The nurse assesses the patient's current state, including pain levels, strength, and potential home environment limitations. Based on this assessment, the nurse might implement interventions like physical therapy, pain management strategies, and home safety assessments to help the patient achieve the desired outcome of independent living.

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CCCR Model: A Systems Approach to Care Coordination

The CCCR model, built upon the foundation of the OPT model, emphasizes the importance of care coordination across different healthcare settings (Kuiper, 2015). It focuses on four key elements:

1. Patient/Family Centeredness: Similar to the OPT model, the patient and family are central to the care planning process.
2. Shared Decision-Making: Collaboration between the patient, family, and healthcare team ensures everyone is on the same page regarding care goals and interventions.
3. Interprofessional Collaboration: Effective communication and collaboration between nurses, doctors, therapists, social workers, and other healthcare professionals ensure a holistic approach to care.
4. Outcomes Management: Regularly monitoring progress and adapting the plan based on new information ensures optimal patient care.

Example of CCCR in Action:

Imagine a patient with diabetes struggling to manage their blood sugar levels. The nurse, using the CCCR model, would involve the patient and family in setting goals for blood sugar control. They would then collaborate with the doctor to adjust medication if needed, work with a dietician to develop a personalized meal plan, and potentially refer the patient to a diabetes education program. This interdisciplinary approach addresses the patient's medical, nutritional, and educational needs, promoting better outcomes.

Combining OPT and CCCR for Optimal Care

The OPT and CCCR models are complementary. The OPT model provides a framework for understanding individual patient needs and setting specific goals. The CCCR model expands upon this by considering the broader healthcare system and the need for collaboration in achieving those goals. By using both models, nurses can ensure patient-centered care that is not only effective but also well-coordinated across all aspects of the patient's journey.

Reference List

• Kuiper, R. A. (2015). Care coordination clinical reasoning: Contemporary competency expectations. In J. C. Catapano, & S. S. Doherty (Eds.), Clinical reasoning for care coordination in advanced practice nursing (pp. 3-20). Springer Publishing Company. https://www.springerpub.com/clinical-reasoning-and-care-coordination-in-advanced-practice-nursing-9780826131836.html
• Tyo, M. A., Lewis, S. L., Stanley, D. M., & McEwen, M. (2019). Clinical reasoning models for advanced practice nurses. Journal of the American Association of Nurse Practitioners, 31(2), 88-94. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7996191/