Care Redesign A Higher-Quality, Lower-Cost Model for Acute Care

被引：6

作者：

Rudisill, Pamela T. ^{[1
]}

Callis, Carlene ^{[2
,3
]}

Hardin, Sonya R. ^{[4
]}

Dienemann, Jacqueline ^{[5
,6
]}

Samuelson, Melissa ^{[7
]}

机构：

[1] Community Hlth Syst, Franklin, TN 37067 USA

[2] HCA, Strateg Resource Grp, Nashville, TN USA

[3] HCA, Strateg Planning Amer Grp, Nashville, TN USA

[4] E Carolina Univ, Coll Nursing, Greenville, NC USA

[5] UNC Charlotte, Sch Nursing, Charlotte, NC USA

[6] Carolinas Med Ctr Univ, Charlotte, NC USA

[7] Poplar Bluff Reg Med Ctr, Poplar Bluff, MO USA

来源：

JOURNAL OF NURSING ADMINISTRATION | 2014年 / 44卷 / 7-8期

关键词：

PATIENT ALLOCATION; NURSING-CARE; SKILL-MIX; HOSPITALS;

D O I：

10.1097/NNA.0000000000000088

中图分类号：

R47 [护理学];

学科分类号：

1011 ;

摘要：

OBJECTIVE: The aims of this study were to design, pilot, and evaluate a care team model of shared accountability on medical-surgical units. BACKGROUND: American healthcare systems must optimize professional nursing services and support staff due to economic constraints, evolving Federal regulations and increased nurse capabilities. METHODS: A redesigned model of RN-led teams with shared accountability was piloted on 3 medical/surgical units in sample hospitals for 6 months. Nursing staff were trained for all functions within their scope of practice and provided education and support for implementation. RESULTS: Clinical outcomes and patient experience scores improved with the exception of falls. Nurse satisfaction demonstrated statistically significant improvement. Cost outcomes resulted in reduced total salary dollars per day, and case mix-adjusted length of stay decreased by 0.38. CONCLUSION: Innovative changes in nursing care delivery can maintain clinical quality and nurse and patient satisfaction while decreasing costs.

引用

页码：388 / 394

页数：7

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