Impact of Patient Safety Initiatives on Nursing Workflow and Productivity

患者安全举措对护理工作流程和生产力的影响

• 批准号: 7545735
• 负责人: MARY A. BLEGEN
• 金额: $ 5万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-05-05 至 2009-05-04
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7545735
• 关键词: Impact; Patient; Safety; Initiatives; Nursing

DESCRIPTION (provided by applicant): Title: Impact of Patient Safety Initiatives on Nursing Workflow and Productivity Abstract Since 2000, the public's attention has been captured by the reports of poor quality, safety risks, and errors in health care. Healthcare organizations, led by the AHRQ, CMS, and voluntary organizations, have instituted wave after wave of system interventions to improve quality and protect patients from errors. The interventions are important to quality and safety but they do increase demands on nurses' time in ways that are not currently measured. An invitational conference will be planned for fall of 2008 to address the impact of the rapid expansion of safety and quality activities on the workload of Registered Nurses caring for hospitalized patients. The goal of the project is to set the stage for determining the impact of the multiple, concurrent, internally and externally driven safety initiatives on nursing workflow, work demands, and productivity and subsequently on the overall quality and safety of patient care. The specific aims of the conference include: (a) Refine a conceptual framework explicating all factors affecting nurses' workload in acute care settings; (b) Achieve consensus on a research agenda and suggested measures and methods to describe nursing productivity, workload, workflow, and cost in relation to practice changes to improve safety and quality of care; and identify specific points at which these safety interventions increase workload and alter productivity; and (c) Explore staffing model changes and methods of streamlining support structures to accommodate the activities involved in patient safety initiatives. Invitees will include (a) persons who are studying nurses' workload measurement, nursing productivity, and the impact of patient safety initiatives; (b) those that hold positions in hospital administration who are accountable for patient safety initiatives and managing the work of health care practitioners, and (c) experts in research designs and analysis techniques for studying system issues. We will contract with selected scholars to produce and present up-to- date reviews of research on measuring nursing workload, work demands, and productivity; patient need for nursing care (intensity/severity); relevant data currently available; and policy relevant measurement. Nursing administration leaders will be asked to describe from their perspective the impact on their nursing staff of system interventions to improve patient safety and other pertinent challenges. Experts in design, measurement, and analysis of data will provide critique and guidance as suggestions for the research agenda and methods emerge. The proceedings of the conference including the initial review papers and the results of the discussion among participants and with the methods consultants will be disseminated through electronic means, publications in peer-reviewed journals, and presentations to stakeholders. Key Personnel Mary A. Blegen Director Nancy Donaldson Co-Director Jean Ann Seago Co-Director Susan Shapiro Co-Director Project Narrative There has been a rapid expansion of the safety and quality activities expected of Registered Nurses caring for hospitalized patients. Protecting patients from errors and omissions in their care is a crucial element of the nurses' role; however, we do not know the impact of these new multiple, concurrent, internally and externally driven, safety initiatives on nursing workflow, work demands, and productivity and subsequently on the overall quality and safety of patient care. This conference will bring together experts on the work of nurses and on ways to measure that work in order to develop valid approaches to studying this increase in work demands.

摘要自2000年以来，公众的注意力一直被医疗保健质量差、安全风险和错误的报道所吸引。由AHRQ、CMS和志愿组织领导的医疗保健组织已经建立了一波又一波的系统干预措施，以提高质量并保护患者免受错误的伤害。这些干预措施对质量和安全很重要，但它们确实以目前无法衡量的方式增加了对护士时间的需求。计划在2008年秋季召开一次邀请会议，讨论安全和质量活动迅速扩大对照顾住院病人的注册护士工作量的影响。该项目的目标是为确定多重、并发、内部和外部驱动的安全举措对护理工作流程、工作需求和生产力的影响，以及随后对患者护理的整体质量和安全的影响奠定基础。会议的具体目标包括：(a)完善一个概念框架，说明影响急性护理环境中护士工作量的所有因素；(b)就研究议程达成共识，并建议措施和方法，描述与实践变化有关的护理生产力、工作量、工作流程和成本，以提高安全性和护理质量；并确定这些安全干预措施增加工作量和改变生产力的具体点；(c)探索人员配置模式的变化和精简支持结构的方法，以适应患者安全倡议所涉及的活动。被邀请者将包括(a)研究护士工作量测量、护理生产力和患者安全措施影响的人员；(b)在医院行政部门担任负责病人安全措施和管理医护人员工作的人员，以及(c)研究系统问题的研究设计和分析技术专家。我们将与选定的学者签订合同，就衡量护理工作量、工作需求和生产力的研究进行最新的综述；患者护理需求（强度/严重程度）；目前可获得的有关数据；与政策相关的衡量。护理管理领导将被要求从他们的角度描述系统干预对护理人员的影响，以改善患者安全和其他相关挑战。数据设计、测量和分析方面的专家将对研究议程和方法提出建议，并提供批评和指导。会议记录，包括初步审查文件和与会者之间以及与方法顾问讨论的结果，将通过电子手段、同行评议期刊上的出版物以及向利益攸关方的报告进行传播。主要人员玛丽·a·布莱根主任南希·唐纳森联合主任珍·安·西戈联合主任苏珊·夏皮罗联合主任项目叙述注册护士护理住院病人的安全和质量活动迅速扩大。保护患者免受护理中的错误和遗漏是护士角色的关键要素；然而，我们不知道这些新的、多重的、并发的、内部和外部驱动的安全举措对护理工作流程、工作需求、生产力以及随后对患者护理的整体质量和安全的影响。这次会议将汇集关于护士工作和衡量工作方法的专家，以便制定有效的方法来研究工作需求的增加。