Revision of hospital work organization using nurse and healthcare assistant workload indicators as decision aid tools
| Autor: | Gérard Garnier, Mercédès Michel, Isabelle Briatte, Caroline Allix-Beguec |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Change process
Cost-Benefit Analysis Staffing Nurses Health administration Decision Support Techniques InformationSystems_GENERAL 03 medical and health sciences 0302 clinical medicine Patient satisfaction Information management Nursing Hospital Administration Pregnancy Health care Medicine Humans 030212 general & internal medicine Prospective Studies Workforce planning business.industry 030503 health policy & services Health Policy Nursing research lcsh:Public aspects of medicine Resource management Healthcare Workload lcsh:RA1-1270 Quality Improvement Hospitals Workforce Female 0305 other medical science business Research Article |
| Zdroj: | BMC Health Services Research BMC Health Services Research, Vol 19, Iss 1, Pp 1-9 (2019) |
| ISSN: | 1472-6963 |
| Popis: | 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. Electronic supplementary material The online version of this article (10.1186/s12913-019-4376-7) contains supplementary material, which is available to authorized users. |
| Databáze: | OpenAIRE |
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