A model for evaluating systemic change: measuring outcomes of hospital discharge education redesign.

Hospitals have restructured job duties and responsibilities in response to market pressures and in an effort to improve quality. This study presents a model for evaluating patient satisfaction outcomes following a work redesign that included the realignment of responsibility for discharge education from clinical nurse specialists to cross-trained, multidisciplinary workers. The outcomes data cannot be generalized, as they relate to a particular redesign and one institution. However, this analysis provides a framework for a systematic, multidisciplinary approach to evaluating organizational change.

Installing computers in older adults' homes and teaching them to access a patient education web site: a systematic approach.

This article describes the experiences of nurses who, as part of a large clinical trial, brought the Internet into older adults' homes by installing a computer, if needed, and connecting to a patient education Web site. Most of these patients had not previously used the Internet and were taught even basic computer skills when necessary. Because of increasing use of the Internet in patient education, assessment, and home monitoring, nurses in various roles currently connect with patients to monitor their progress, teach about medications, and answer questions about appointments and treatments. Thus, nurses find themselves playing the role of technology managers for patients with home-based Internet connections. This article provides step-by-step procedures for computer installation and training in the form of protocols, checklists, and patient user guides. By following these procedures, nurses can install computers, arrange Internet access, teach and connect to their patients, and prepare themselves to install future generations of technological devices.