ABSTRACT
Across British Columbia Cancer (BC Cancer), oncology nurses work as part of an interdisciplinary team in the outpatient ambulatory care unit (ACU) and support patients across the trajectory of their cancer journey. Previous initiatives, which focused on identifying patient needs and nursing role optimization work, have enhanced role clarity, enabling nurses to articulate their scope of practice and specialty competencies required to best meet the needs of patients and families. However, while the patient needs and fundamental practice elements have been identified to optimize the ACU nursing role, a gap still exists in quantifying the staffing resources required to operationalize the current model of care. To address this gap, a quality improvement project was initiated to develop an internally validated ACU Nursing Resource Intensity Weighting (RIW) tool for projecting baseline staffing requirements. The tool can be utilized to inform strategic and operational planning discussions focused on improving the outpatient model of care in oncology.
ABSTRACT
BACKGROUND: In British Columbia, the Nursing Policy Secretariat of the Ministry of Health recently issued a series of priority nursing recommendations, including team-based care delivery models. AIM: This paper will describe the data collection and analysis phase of a quality improvement initiative focused on care delivery redesign within three healthcare organizations. The focus of the care delivery redesign was a transition from total nursing care to team-based nursing care. METHODS: Our leadership-academic partnership used the Canadian Nurses Association's "Staff Mix Decision-Making Framework for Quality Nursing Care" to guide data collection and analysis on patient, nurse and organizational factors. Data were collected by nurse-led project teams using a patient needs assessment tool, surveys of nurses' scope of practice and teamwork and an environmental profile tool with nurse demographics and unit/facility-level characteristics. RESULTS: Findings from one organization's pediatric medicine and surgery units are presented in this paper. CONCLUSION: Quality improvement data provide multiple opportunities for proactive human resource planning and professional development. Resources and examples are provided to guide others' redesign efforts.
