Revision of hospital work organization using nurse and healthcare assistant workload indicators as decision aid tools.
Background: Historically, governmental hospital organisation consisted in a heterogeneous distribution of staff and a fragmented logistical organisation without cross-functionality or sharing of resources between departments. This organisation could not last in a context of an evolving healthcare en...
| Published in: | BMC Health Services Research Vol. 19; no. 1 |
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| Main Authors: | , , , |
| Format: | Journal Article |
| Published: |
BioMed Central
8/7/2019
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=137944364&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 137944364 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 14726963 1CHS jtl: BMC Health Services Research issn: 14726963 maglogo: N pubinfo: dt: 8/7/2019 vid: 19 iid: 1 pid: 24147 pub: BioMed Central artinfo: ui: 137944364 137944364 NLM31391052 10.1186/s12913-019-4376-7 NLM31391052 137944364 ppct: 1 formats: tig: atl: Revision of hospital work organization using nurse and healthcare assistant workload indicators as decision aid tools. aug: au: Briatte, Isabelle Allix-Béguec, Caroline Garnier, Gérard Michel, Mercédès affil: Coordination générale des soins, Groupe Hospitalier de la Rochelle Ré Aunis, CH La Rochelle, rue du Dr Schweitzer, 17019, La Rochelle, France sug: subj: Quality Improvement Administration Hospitals Pregnancy Female Health Facility Administration Decision Support Techniques Cost Benefit Analysis Prospective Studies Clinical Assessment Tools Ferrans and Powers Quality of Life Index Scales Short Portable Mental Status Questionnaire Female ab: Background: Historically, governmental hospital organisation consisted in a heterogeneous distribution of staff and a fragmented logistical organisation without cross-functionality or sharing of resources between departments. This organisation could not last in a context of an evolving healthcare environment, changing patient profiles and hospital expenditure constraints. Cost-effective workforce regulation for optimal patient quality of care was urgently needed. The purpose of the study was to describe the reorganization that led to resource management no longer based on what has been achieved but based on a daily measured workload.Methods: This prospective study used nursing intensity indicator, mirroring patient care needs, which was reported daily using VALPAReSO® software. Indirect care activities were recorded in departments of medicine, surgery and obstetrics. Based on data collected in 2012, a new organisation strategy was implemented and evaluated in 2015.Results: Nursing intensity indicator analysis led to a reallocation of workforce per department, and the reinforcement unit (float pool) was managed based on this decision-aid tool for replacement and daily adequate staffing. The healthcare workflow audit resulted in the revision of five working tasks: time spent on handover, working time management, connections between services and the pharmacy, housekeeping, and food management. The reorganization took place at the same time as the transition to the development of very short-term care, resulting in a decrease in the number of full inpatient beds, which were therefore mainly occupied by heavier care profile patients. With the integrated strategy, this transition was achieved with constant staffing, and good overall patient satisfaction and working conditions were maintained.Conclusion: The reorganisation strategy was managed in a context of institutional commitment, coaching leadership built on close manager-employee interaction, a defragmented management between healthcare and all service providers, and a seamlessly dissemination and sharing of indicator information between healthcare managers, nurses and healthcare assistants. The process optimization allowed a better allocation of tasks and enabled nurses to refocus on patient care. Nursing intensity and indirect care indicators, when widely accepted, can be used as decision support tools for daily adequate staffing. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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