ABSTRACT
The population of alternate level care (ALC) patients utilizing acute-care hospital resources inappropriate to their needs is growing. The purpose of this study was to explore how the care of ALC patients was managed at 4 acute-care facilities in the Canadian province of British Columbia and to examine how this care impacts on outcomes of staff injury. Interviews were conducted to identify and characterize the different models of ALC. Injury outcomes for all caregivers were obtained (n = 2,854) and logistic regression conducted to compare staff injuries across ALC models. Injured workers were surveyed regarding their perceptions of injury risk and ALC. Five ALC models were identified: low-mix, high-mix, dedicated ALC units, extended care units, and geriatric assessment units. The risk for caregiver injuries was lowest on dedicated ALC units. These findings suggest that acute-care facilities faced with a growing ALC population should consider creating dedicated ALC units.
Subject(s)
Accidents, Occupational , Attitude of Health Personnel , Geriatric Nursing/organization & administration , Health Services Misuse/statistics & numerical data , Health Services for the Aged/organization & administration , Nursing Staff, Hospital , Absenteeism , Accidents, Occupational/prevention & control , Accidents, Occupational/statistics & numerical data , Adult , Aged , British Columbia , Choice Behavior , Follow-Up Studies , Humans , Lifting/adverse effects , Logistic Models , Models, Nursing , Models, Organizational , Nursing Methodology Research , Nursing Staff, Hospital/organization & administration , Nursing Staff, Hospital/psychology , Occupational Health , Outcome Assessment, Health Care , Patient Selection , Qualitative Research , Risk Factors , Surveys and QuestionnairesABSTRACT
In British Columbia (BC), Canada, a partnership of researchers, healthcare employers, and healthcare unions reduced high injury rates through examining determinants of healthy workplaces and designing, implementing, and evaluating interventions. Over 51 million dollars (Canadian) was saved from the BC healthcare budget over two years, largely attributable to the collaborative effort. Challenges and rewards of the process were determined from interviews and workshops with researchers and community stakeholders, and by obtaining direct input to this report. Challenges included maintaining communication and trust between partners, preserving partnerships during restructuring and labor disputes, and maintaining involvement and support of front-line workers and senior management. As all partners recognized the importance of the research agenda, the stakeholders remained committed to working through the challenges, and have consequently achieved considerable success.
