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Introduction of a team-based care model in a general medical unit.

Hastings SE, Suter E, Bloom J, Sharma K - BMC Health Serv Res (2016)

Bottom Line: Responses from staff surveys were also very positive, showing significant positive changes in most areas.Administrative data showed slight decreases in overall length of stay, 30-day readmissions, staff absenteeism, staff vacancies, and the overtime rate.There were also a few positive effects on patient care suggesting that models such as this one could improve the organization's ability to deliver sustainable, high-quality, patient- and family-centred care without compromising quality.

View Article: PubMed Central - PubMed

Affiliation: Alberta Health Services, 10301 Southport Lane SW, Calgary, AB, T2W 1S7, Canada. Stephanie.hastings@ahs.ca.

ABSTRACT

Background: Alberta Health Services is a provincial health authority responsible for healthcare for more than four million people. The organization recognized a need to change its care delivery model to make care more patient- and family-centred and use its health human resources more effectively by enhancing collaborative practice. A new care model including changes to how providers deliver care and skill mix changes to support the new processes was piloted on a medical unit in a large urban acute care hospital Evidence-based care processes were introduced, including an initial patient assessment and orientation, comfort rounds, bedside shift reports, patient whiteboards, Name Occupation Duty, rapid rounds, and team huddles. Small teams of nurses cared for a portion of patients on the unit. The model was intended to enhance safety and quality of care by allowing providers to work to full scope in a collaborative practice environment.

Methods: We evaluated the new model approximately one year after implementation using interviews with staff (n = 15), surveys of staff (n = 25 at baseline and at the final evaluation) and patients (n = 26 at baseline and 37 at the final evaluation), and administrative data pulled from organizational databases.

Results: Staff interviews revealed that overall, the new care processes and care teams worked quite well. Unit culture and collaboration were improved, as were role clarity, scope of practice, and patient care. Responses from staff surveys were also very positive, showing significant positive changes in most areas. Patient satisfaction surveys showed a few positive changes; scores overall were very high. Administrative data showed slight decreases in overall length of stay, 30-day readmissions, staff absenteeism, staff vacancies, and the overtime rate. We found no changes in unit length of stay, 30-day returns to emergency department, or nursing sensitive adverse events.

Conclusions: Conclusions from the evaluation were positive, providing initial support for the idea of the collaborative practice model vision for adult medical units across Alberta. There were also a few positive effects on patient care suggesting that models such as this one could improve the organization's ability to deliver sustainable, high-quality, patient- and family-centred care without compromising quality.

No MeSH data available.


Related in: MedlinePlus

Unit A staff survey pre-post comparisons
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Fig1: Unit A staff survey pre-post comparisons

Mentions: We compared the scale means on the final evaluation survey to the baseline survey using independent two-tailed t-tests because we had no way to match baseline and final evaluation surveys and there was a strong likelihood that the surveys were not completed by the same staff members at each time point. We found several significant improvements since the new model was introduced (Fig. 1). Responses increased significantly for perceptions of quality of patient care (4.2 at post-test vs. 3.5 at pre-test; p < .001), manager support (4.5 vs. 3.9; p = .05), role clarity (4.1 vs. 3.6; p < .05), time and autonomy (4.0 vs. 3.0; p < .001), scope (4.6 vs. 4.1; p < .05), and collaboration and communication (4.4 vs. 3.4; p < .001).Fig. 1


Introduction of a team-based care model in a general medical unit.

Hastings SE, Suter E, Bloom J, Sharma K - BMC Health Serv Res (2016)

Unit A staff survey pre-post comparisons
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4940946&req=5

Fig1: Unit A staff survey pre-post comparisons
Mentions: We compared the scale means on the final evaluation survey to the baseline survey using independent two-tailed t-tests because we had no way to match baseline and final evaluation surveys and there was a strong likelihood that the surveys were not completed by the same staff members at each time point. We found several significant improvements since the new model was introduced (Fig. 1). Responses increased significantly for perceptions of quality of patient care (4.2 at post-test vs. 3.5 at pre-test; p < .001), manager support (4.5 vs. 3.9; p = .05), role clarity (4.1 vs. 3.6; p < .05), time and autonomy (4.0 vs. 3.0; p < .001), scope (4.6 vs. 4.1; p < .05), and collaboration and communication (4.4 vs. 3.4; p < .001).Fig. 1

Bottom Line: Responses from staff surveys were also very positive, showing significant positive changes in most areas.Administrative data showed slight decreases in overall length of stay, 30-day readmissions, staff absenteeism, staff vacancies, and the overtime rate.There were also a few positive effects on patient care suggesting that models such as this one could improve the organization's ability to deliver sustainable, high-quality, patient- and family-centred care without compromising quality.

View Article: PubMed Central - PubMed

Affiliation: Alberta Health Services, 10301 Southport Lane SW, Calgary, AB, T2W 1S7, Canada. Stephanie.hastings@ahs.ca.

ABSTRACT

Background: Alberta Health Services is a provincial health authority responsible for healthcare for more than four million people. The organization recognized a need to change its care delivery model to make care more patient- and family-centred and use its health human resources more effectively by enhancing collaborative practice. A new care model including changes to how providers deliver care and skill mix changes to support the new processes was piloted on a medical unit in a large urban acute care hospital Evidence-based care processes were introduced, including an initial patient assessment and orientation, comfort rounds, bedside shift reports, patient whiteboards, Name Occupation Duty, rapid rounds, and team huddles. Small teams of nurses cared for a portion of patients on the unit. The model was intended to enhance safety and quality of care by allowing providers to work to full scope in a collaborative practice environment.

Methods: We evaluated the new model approximately one year after implementation using interviews with staff (n = 15), surveys of staff (n = 25 at baseline and at the final evaluation) and patients (n = 26 at baseline and 37 at the final evaluation), and administrative data pulled from organizational databases.

Results: Staff interviews revealed that overall, the new care processes and care teams worked quite well. Unit culture and collaboration were improved, as were role clarity, scope of practice, and patient care. Responses from staff surveys were also very positive, showing significant positive changes in most areas. Patient satisfaction surveys showed a few positive changes; scores overall were very high. Administrative data showed slight decreases in overall length of stay, 30-day readmissions, staff absenteeism, staff vacancies, and the overtime rate. We found no changes in unit length of stay, 30-day returns to emergency department, or nursing sensitive adverse events.

Conclusions: Conclusions from the evaluation were positive, providing initial support for the idea of the collaborative practice model vision for adult medical units across Alberta. There were also a few positive effects on patient care suggesting that models such as this one could improve the organization's ability to deliver sustainable, high-quality, patient- and family-centred care without compromising quality.

No MeSH data available.


Related in: MedlinePlus