ABSTRACT
This article is the fourth of a four-part series on the University Hospital Nurse Extender Model using patient care technicians (PCTs). Part I provided the overview and conceptual framework for the model. Part II described the implementation process. Part III described the 1-year evaluation of the impact of the model. Part IV presents six lessons learned from this attempt to alter the way nursing care is delivered to patients. The lessons include the steps that must precede implementation, the role of leadership, the importance of clearly conveyed goals, the need for realistic incentives, and the necessity of a clearly defined communication system among those involved in the implementation.
Subject(s)
Nursing Assistants , Nursing Staff, Hospital/organization & administration , Hospitals, University , Humans , Massachusetts , Nurse Administrators , Nursing Staff, Hospital/supply & distribution , Organizational InnovationABSTRACT
This article is the third part of a four-part series on The University Hospital Nurse Extender Model Using Patient Care Technicians. Part I provided the overview and conceptual framework for the model. Part II described each phase of the implementation process. This article presents the results of a 1-year evaluation of the impact of the model on nursing practice and satisfaction, and the cost of using the model. Part IV will present the lessons learned from this attempt to reconfigure patient care delivery.
Subject(s)
Job Satisfaction , Models, Nursing , Nursing Staff, Hospital/psychology , Patient Care Team/standards , Primary Nursing/standards , Cost-Benefit Analysis , Hospitals, University , Humans , Job Description , Nursing Administration Research , Nursing Assistants/statistics & numerical data , Nursing Staff, Hospital/statistics & numerical data , Nursing Staff, Hospital/supply & distribution , Patient Care Team/economics , Patient Care Team/organization & administration , Primary Nursing/economics , Primary Nursing/organization & administration , Program Evaluation , Surveys and QuestionnairesABSTRACT
This second article in a four-part series provides a detailed discussion of each phase of the implementation process, along with a demographic summary of the University Hospital Patient Care Technicians' Program 2 years after program implementation. Part I provided the overview and conceptual framework for the model. Parts III and IV will present the results of a year-long evaluation of the model and the lessons learned during the implementation process.
Subject(s)
Hospitals, University , Nursing Assistants/statistics & numerical data , Nursing Service, Hospital , Female , Humans , Male , Massachusetts , Models, Nursing , Nursing Assistants/education , Patient Care Team , Personnel Turnover , Program Evaluation , WorkforceABSTRACT
The University Hospital Nurse Extender Model using patient care technicians is a long-term strategy to maintain quality patient care. The authors present an overview and conceptual framework of the model. In future papers in this four-part series, the authors will discuss the implementation and evaluation of the model and describe six lessons learned during the implementation process. This information will be useful to any nursing administrator planning to implement a change in the way patient care is delivered.
Subject(s)
Hospitals, University , Models, Nursing , Nursing Assistants , Nursing Staff, Hospital/trends , Boston , Hospital Bed Capacity, 300 to 499 , Humans , Nursing Assistants/education , Nursing, Team/organization & administration , Personnel Staffing and Scheduling/trends , Pilot Projects , WorkforceABSTRACT
Complex national factors went into the development of key policies of the federal prospective payment system, and the effects of these policies varied in different parts of the country. One state particularly affected by these changes, and for the most part in a positive way, was New York. This paper focuses on the Medicare PPS policy changes and their impact nationally. An analysis of the experience of New York state, which had been under a stringent hospital cost containment system before PPS, provides a laboratory to understand how key federal policies affected different types of hospitals in that state as well as nationally.
