A STUDY OF APPROACHES FOR IMPROVING THE QUALITY OF CARE MANAGERS

为了全面了解和了解长期护理保险计划居家护理科护理员的工作内容，我们对护理员的日常工作情况进行了为期一个月的时间研究（37例）。本研究专门针对护理管理的实际工作条件，提高护理管理人员的素质，寻找和开发提高护理管理人员技能水平的方法，以维持和提高护理质量。根据护理管理流程对工作进行编码，并根据护理管理人员提供的工作类型、对谁、使用什么方法和工作时间的每日记录计算总工作时间。结果如下：(1)从实际工作时数来看，51%的护理经理有其他工作，并兼任护理经理（以下简称“兼职工作人员”）。平均工作时间为191小时37分钟，最长为332小时34分钟，最短为108小时。兼职工作管理者的平均工作时间为211小时，尽管全职工作管理者和兼职工作管理者在案例数量上没有显著差异（平均为54.3小时），但兼职工作管理者的休假天数仅为全职工作管理者的三分之二，这使得兼职工作管理者的实际工作时间大大增加。兼职护理员比全职护理员花费更多的时间在护理管理的核心工作上，如评估、制定护理计划和监测。此外，兼职护理经理和全职护理经理在护理管理之外的工作量都有显著增加。这类工作占整体工作的比例很高，平均为31%，而对于兼职工作持有人护理经理来说，这一比例为37%。(3)通常情况下，没有召开每项服务负责人的会议。此外，在英国，护理管理者的教育和研究侧重于(1)系统和结构的发展、维护和评估，以促进人们的权利、责任和多样性；(2)为个人实现最佳结果的服务管理；(3)财务资源的管理和使用；(4)团队和个人绩效的管理。获得这些科目的学分是成为注册护理经理的强制性要求。时间研究的结果需要进一步进行详细的评估，并参考英国的数据和情况，对日本护理管理者教育和研究的发展方案，以及工作环境的改善，如扣减病例数等也需要重新进行评估。少

In order to fully comprehend and understand the work content of care managers working under the Home Care Division within the Long Term Care Insurance Plan, a time study (37 cases) was conducted for a period of one month regarding the daily working conditions of care managers. This study, specifically focused on the actual working conditions of care management to improve the quality of care managers and to find and develop methods to improve the skill level of care managers in order to maintain and enhance the quality of care. Work was coded based on the care management process and the aggregate working hours were calculated based on the everyday record of the type of work provided by the care managers, toward whom, using what method and for how long. As a result, the following can be stated : (1)By looking at the hours actually worked, 51% of the care managers had other work and worked as care managers concurrently (hereafter "Concurrent Job Holders"). The average number of hours work … More ed overall was 191 hours 37 minutes, the maximum being 332 hours 34 minutes and the minimum at 108 hours. The Concurrent Job Holder care managers averaged 211 hours and although there was not a significant difference in the number of cases (averaging at 54.3) between the full-time and Concurrent Job Holders, the Concurrent Job Holders only had 2/3rds the number of days off compared to the full-timers making the number of hours actually worked by Concurrent Job Holder care managers substantially greater, (2)By looking at the content of the work, Concurrent Job Holder care managers spent longer hours on work which Is the core of care management, such as assessment, developing care plans and monitoring than the full-time care managers. Further, the amount of work other than care management showed substantial increase for both Concurrent Job Holder care managers and full-time care managers. Such work covers a high percentage at an average of 31% of the overall work and for the Concurrent Job Holder care managers specifically, 37% of their work, and (3)In general, a meeting of those in charge of each service is not being held.Further, in England, the education and research of care managers focuses on (1)the development, maintenance and evaluation of systems and structures to promote the rights, responsibilities and diversity of people, (2)management of services which achieves the best possible outcome for the individual, (3)management and use of financial resources and (4)management of the performances of the team and individual. Acquisition of credits of such subjects are mandatory to become a registered care manager. The results of the time-study should be further evaluated in detail, and referring to the data and situation of England, the development program of the education and research of care managers in Japan, together with the improvement of the working environment such as the deduction of the number of cases should also be re-evaluated. Less