Impact of Patient Safety Initiatives on Nursing Workflow and Productivity

描述（由申请人提供）：标题：患者安全措施对护理工作流程和生产力的影响摘要自2000年以来，公众的注意力已经被质量差，安全风险和医疗保健错误的报告所吸引。由AHRQ、CMS和志愿组织领导的医疗保健组织已经制定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影响。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要求。计划于2008年秋季举行一次邀请会议，讨论安全和质量活动的迅速扩大对护理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个并发的内部和外部驱动的安全措施对护理工作流程，工作需求和生产力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，阐明影响护士在急症护理环境中工作量的所有因素;（B）就研究议程和建议的措施和方法达成共识，以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，以改善护理安全和质量;并确定这些安全干预措施增加工作量并改变生产力的具体点;以及（c）探索人员配置模式的变化和简化支持结构的方法，以适应患者安全举措所涉及的活动。受邀者将包括（a）正在研究护士工作量测量、护理生产率和患者安全举措影响的人员;（B）在医院管理部门任职的人员，他们负责患者安全举措和管理医疗保健从业人员的工作;以及（c）研究系统问题的研究设计和分析技术方面的专家。我们将与选定的学者签订合同，以生产和提出最新的研究综述测量护理工作量，工作需求和生产力;病人对护理的需求（强度/严重程度）;目前可用的相关数据;和政策相关的测量。护理管理领导者将被要求从他们的角度描述系统干预措施对护理人员的影响，以改善患者的安全和其他相关的挑战。设计，测量和数据分析方面的专家将为研究议程和方法的建议提供批评和指导。会议记录，包括初步审查文件以及与会者之间和与方法顾问的讨论结果，将通过电子手段、在同行审查的期刊上发表以及向利益攸关方介绍等方式传播。关键人员玛丽A.布莱根主任南希唐纳森联合主任吉恩安西戈联合主任苏珊夏皮罗联合主任项目叙述有一个快速扩展的安全和质量活动的预期注册护士照顾住院病人。保护患者在护理中免受错误和遗漏的影响是护士角色的关键要素;然而，我们不知道这些新的多重、并发、内部和外部驱动的安全措施对护理工作流程、工作需求和生产力以及随后对患者护理的整体质量和安全的影响。这次会议将汇集专家对护士的工作和如何衡量工作，以制定有效的方法来研究这种增加的工作需求。

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.