Final Flashcards
Describes the structure and processes by which responsibilities for patient care area assigned and the means by which the work is coordinated among caregivers.
workforce management
describes the mechanism for documenting and reporting staffing concerns
workforce management
A method or system for organizing and delivering nursing care
patient care delivery model
includes the manner in which nursing care is organized to deliver the care necessary to meet the needs of the patient.
patent care delivery model
The patient care delivery model encompasses:
work delegation resource utilization communication methodologies clinical decision making processes management structure
A ____ approach is needed with all disciplines, focusing on continuity of care service.
systems
patient care delivery model where work is assigned by tasks
functional nursing
patient care delivery model where a nurse is assigned as the lead caregiver to plan and coordinate care
primary nursing
patient care delivery model where a team provides care based on tasks and skills levels and competence
team nursing
patient care model where a two person team prvides care to groups of patients
modular nursing
patient care model where a nurse coordinates care using clinical pathways and quality criteria
care management nursing
Patient workforce management includes:
- est. of pt. care delivery model
- ID pt. care needs & nurse interventions
- creation of core staffing schedule
- daily staffing process match w/ pt. care needs
- evaluation of value & outcomes
4 areas of focus to complete work in a digital complex world:
divide knowledge work into discrete, assignable tasks
recruitment of workers based on work pieces
assurance of work quality
integration of the work pieces
assignment of work should be based on:
skills, licensure & competence
The optimal delivery model for the future is driven by ___ and ___ and ensures ___ & the achievement of ___
principles & assumptions; coordination of efforts; value based outcomes
HIstorically staffing patterns were based on:
what was needed in the previous year
The underlying assumption of a staffing grid or ratio-based staffing is that:
all patient’s are similiar in needs
Advantages of nurse-patient ratios:
- considers historical average patient acuity
- provides incentives for nurses to return to bedside
- uses simple to regulate #s
- increases nurse satisfaction
- alleviates nurse stress
- marginally supported by evidence
- provides a short term solution to complex problem
Disadvantages of nurse-patient ratios:
- doesn’t fix the problem
- doesn’t consider evidence for effective staffing
- may become max. staffing levels rather than min.
- does not consider variation in pt. needs
- does not consider variation in staff competence
- assumes nurses are able to meet ratios
- forces closure of some hospitals
- devalues nurse’s critical thinking
- assumes a manufacturing model is appropriate for pt. care
- shifts staffing accountability to the government
With recent healthcare reform legislation, the emphasis has shifted from ___ model to a ____ ___ model that integrates all settings in which patient care is provided
event-based; continuum accountability
The creation of DRGs was mostly for what purpose?
billing
What were the areas of nurses work that were not being addressed before the patient classification system emerged?
patient education
family support
interdisciplinary collaboration
The goal of a patient classification system is to provides the most ___ an d___ information specific to work that needs to be done for patients.
valid; reliable
The ordering of entities into groups of classes on tha tbasis of their similarity, minimizing within-group variance and maximinzing between-group variance
classification
The level of need or dependency of an individual patient, measure in hours of care needed by skill level.
patient acuity/intensity
A process of grouping patients into homogenous, mutually exclusive groups to determine their dependency on caregivers or to determine patient acuity.
patient classification
The long-range plan that combinest he organization’s goals, legislation, regulation, and accreditation requirements and planned patient demand.
scheduling
The real-time adjustment of the schedule based on census, acuity, and mix of available resources.
staffing
The comprehensive system that includes patient classification, scheduling, staffing, and budgeting system.
workforce management
___ are taken for cost reduction.
motion studies
___ are performed for cost control reasons.
time studies
___ focus on design
motion studies
___ focus on measurement
time studies
A ____ is designed to determinet he best way to complete a repetitive job.
motion study
A ___ measures the length of time it takes an avergae worker to complete a task at a normal pace.
time study
The technique of ___ samples work activities at systematic or random intervals.
work sampling
Invoels randomly observing people working to determine how they spend their time
work sampling
In healthcare, ___ has been the foundation for some computerized patient classification systems.
work sampling
The extent to which a workforce management system measures what it is designed to measure.
validity
The extent to which data are reproducible.
reliability
The 3 types of reliability include:
stability, homogeneity, and equivalence
The most important type of reliability for workforce management systems is:
equivalence or interrater reliabilty
Refers to the extent to which different nurses use the same workforce system to measure the same individual, at the same time, to derive consistent results.
Equivalence
A tool developed to help clinicans and hospitals monitor quality of care and utilization of services
DRG system
Why we need a patient classification system:
- to understand the relationship among pt. care needs, interventions, outcomes, and the skill level of caergiverrs
- to define the amount of staff needed for a situation
- to create a valid and reliable systemt hat defines and defends the work of professionals
___ is subjecive, but is shown to have high face validity
self-reporting
Uses time standards developed from past experiences.
standard data setting
Standard data setting is specific to the individual environment & typically the __ & ___ to detemrine for manufacturing settings.
most accurate; least costly
The ___ technique attempts to remedy the criticism levied against the __ technique’s inability to capture professional judgment required in health care.
Expert opinion; work sampling
___ ___ is reliable only if the results obtained approximate teh results generated by experts, and the estimates are valid & reliable.
Expert opinion
Much of nursing is __ rather than ___
mind work; hand work
ONe solution for improving the validity and reliability of caregiver work measurement is to attach __ and ___ ___ ___ to clinical interventions in an electronic documentation system.
time; skill mix standards
Present when the reported patienta cuity increases slowly over time but the acutal care does not change.
acuity creep
Fitzpatrick & Brooks identified the role of ___ as logistician
clinical leader
