Introduction
Because of cancer becoming to the leading cause of death, the demand of services in cancer institution is steady increasing in recent years. Certain of researchers indicated that patients spend much more time on waiting, either in waiting to range an appointment or waiting at cancer institutions. Therefore, the paper “Improving Patient Access to Chemotherapy Treatment at Duke Cancer Institute” (Woodall etc, 2013) is aim to improve to the patient flow in their institution, which also focus on to apply in other cancer institutions.
Initially, writers obtain some basic information about Duke Cancer Institute on the information flow among different departments. The departments include clinic, radiology, central laboratory, oncology treatment center (OTC) and pharmacy; the nurse’s types include full-time and part-time. In order to optimize and simulate the processes to meet patients demand and allocate resources, the researchers provide three models to achieve their objectives. As these three models are being analysis step-by-step and the later model is based on previous results.
The first model is ‘discrete-event simulation model’, which is aim to predict patient waiting time and acquire the information on resources utilization among different departments. Nevertheless, researchers identified that the most serious bottleneck is in OTC, because of nurses are unavailable during the treatment process. Therefore researchers decided to key focus on OTC, and made assumptions on maximum patients’ number for each nurse. As a result that OTC is subject to time variability, improve the shift time schedules and working length of nurses will be the better way to distribute nurse’s supply with demand of patients.
Based on the first mode, then they raised to using ‘mixed-integer programming model’ for nurse shifting, to release the bottleneck in OTC. The schedules shifting include daily, weekly and monthly, nurse type include full-time and part-time. This method is used to concentrate on predetermine the amount of nurses on weekly and monthly schedules. The full-time nurse type will be including 10-hours and 8-hours per day. The nurses’ allocation of weekly and monthly is based on daily patients’ demand. As a result, those analysts determine to change one or two full-time nurses into same ability levels of part-time nurses, which is more suitable for OTC peak time demand and reduce resources overuse when there don’t have too much patients.
The final model is based on the previous model to further relieve the bottleneck by optimize the start time and end time on daily nurse shifting. This method is focus on the daily nurse shifting.
There is a surge of retiring nurses and a rising number of patients. Hospitals are scrambling to fill the tens of thousands of nursing positions, therefore, asks the question as to
The Crowded Clinic Case Study (Colorado State University - Global, n.d.) discusses the issues of practice management as they apply to access to care. Access to care may be as inconvenient as lengthy patient wait times to issues far more serious that may have a profound effect on the health and well-being of a single patient or an entire cohort.
In today's health care environment many factors contribute to quality care. As a medical practice manager it is important to provide the best medical service for patients in addition to excellent levels of service. Appointment scheduling is a very important aspect of a smooth running medical practice. Appointment cancellation, no shows, and long waiting time by patients have a negative impact on the efficient running of the practice not only in lost revenue but the practices professional reputation as well (Kruse 2010).
An activity report can provide operational statistics such as occupancy rate, average daily census, and average length of stay (Finkler, Jones & Krover, 2013). Though these numbers are important and have a great influence on the operational budget, a nurse leader needs more information in order to justify staffing. Nurse leaders can obtain additional information from workload reports. Patient classification system measure workload by assigning each patient a classification level based on his or her unique care needs and then determine the number of care hours required per patient per day. Many organizations express this in hours per patient day (HPPD) or relative value units (RVU) (Finkler et al., 2013). Workload reports are useful because they can identify changes in patient mix that can increase or decrease the need for nursing personnel. Bi-weekly fulltime equivalent (FTE) reports are also useful because they convey to nurse leaders exactly how many man-hours were used by each FTE (Liberty University, 2015). Furthermore, the report provides a breakdown of productive time; contract hours, paid time off (PTO), and overtime. It also accounts for nonproductive time such as time spent on education, training, and orientation (Liberty University,
Goal: Improve nursing handoff during change of shift with incoming and outgoing nurses by providing a standard hand of flow sheet, to improve patient safety and quality of care
Due to WellStar being a multi facility health system, its organizational design is constantly being reviewed for simpler and more efficient processes. WellStar’s two smallest hospitals, WellStar Paulding and WellStar Douglas, previously under went reconstruction with regards to their hierarchical structure in Patient Access Services (PAS). WellStar Paulding, the smallest facility of the five hospitals, renovated their managerial chain of command in PAS. WellStar Paulding’s patient volume is less than half in comparison to the 4 additional hospitals. As a result, their staff is smaller and only requires minimal supervision. In the past WellStar Administrators requested supervisors for every department, a manager of the entire department, and a director that managed PAS’ management directly and PAS staff indirectly. Recent cuts ...
Two main staffing methods that are currently used in most nursing facilities are staffing by patient acuity using patient classification systems and staffing by mandated nurse-to-patient rations. Each method has an impact on patient outcomes, safety and overall satisfaction determined from different articles and studies done on each staffing method. There are pros and cons to each staffing methods. Nursing facilities look at many of these pros and cons when determining staffing methods that are used, cost, patient outcomes, and nursing
Thousands of nurses throughout the nation are exhausted and overwhelmed due to their heavy workload. The administrators do not staff the units properly; therefore, they give each nurse more patients to care for to compensate for the lack of staff. There are several reasons to why
The nursing shortage in the healthcare setting, can result in decreased quality of care with the patient and this can have a significant impact on the financial aspect of the organization. As time changes, there are more acute illnesses being presented in the hospital as a result of the patient prolonging to seek medical treatment. The delay in seeking medical treatment often stems from the patient not having health insurance and seeking home remedies as an alternate method of treatment. When the patient present to the hospital with multiple acute illnesses, the staff should be skilled, ready and available to render the necessary treatment for the patient. The idea of nursing shortage, poses the risk and outcome of poor
If the other RNs all agree and look to the nurse manager to make sure that that is an ok solution it shows they all support the initiative taken but still know the nurse manager is the leader. The nurse manager’s response could be that she appreciates the RN’s initiative to find a solution and that she will look at the schedule to see if she thinks that the RN’s solution would work. Also that the RN that switches patients also agrees and is happy to help out others knowing that if that happened to be her then the other RN would also help her out and switch patients. The outcome could be a switch of how the patients are assigned for the time being and that those five unstable, heavy workload patients are not assigned together for any other
Nurse staffing is a complex issue. There are many factors which need to be considered when staffing a nursing unit. Evidence shows an association between Registered Nurses (RNs) having decreased workloads and better patient outcomes, including a decrease in patient mortality (Aiken et al., 2011; Needleman et al, 2011; How Lin, 2013; Patrician et al., 2011; Wiltse-Nicely, Sloane, Aiken, 2013). A small percentage of patients expire during their hospitalization as evidence suggests that a portion of these deaths can be attributed to RN staffing levels (Shekelle, 2013). As the reimbursement system for hospitals today emphasizes quality outcomes, this has an increase in the importance of the nurse’s role in patient care (Frith, Anderson, Tseng, & Fong, 2012). The quality of care is effected when there are higher RN-to-patient ratios. Mortality rates can be decreased by 50% or more when there is a lower RN-to-patient ratio. The morale of nursing staff and the hospital’s reputation are effected when there is a large nurse turnover and poor patient outcomes (Martin, 2015; Knudson, 2013). Having adequate nurse staffing levels saves lives (Martin, 2015). The purpose
The purpose of this paper is to address the issue of nursing staffing ratios in the healthcare industry. This has always been a primary issue, and it continues to grow as the population rate increases throughout the years. According to Shakelle (2013), in an early study of 232,432 surgical discharges from several Pennsylvania hospitals, 4,535 patients (2%) died within 30 days of hospitalization. Shakelle (2014) also noted that during the study, there was a difference between 4:1 and 8:1 patient to nurse ratios which translates to approximately 1000 deaths for a group of that size. This issue can be significantly affected in a positive manner by increasing the nurse to patient ratio, which would result in more nurses to spread the work load of the nurses more evenly to provide better coverage and in turn result in better care of patients and a decrease in the mortality rates.
Notably, having higher proportions of nurses working shorter shifts—8–9 hours or 10–11 hours—resulted in decreases in patient dissatisfaction” (Stimpfel et al.). This is essentially saying that the longer the shift length, the more negative outcomes result. This study proves that eight to nine-hour shifts are more effective, and should, in turn, be worked more than longer shifts. This is a problem because hospitals are likely to continue to schedule nurses for twelve hours shifts out of
Nurse staffing ratios in healthcare is an ongoing issue throughout the country. With healthcare being run like a business, the bottom line is sometimes thought to be more important than the safety of the patients. One will see through this paper that by reviewing patient outcomes and mortality, nurse staffing ratios can affect the quality and safety of patient care. II. Literature Review
Both facilities will have the same Medical Director and one Director of Nursing running both locations. Management personnel will improve their communication by meeting once a week to discuss and brainstorm ideas; bill verification will be consistent in the two facilities; there will be a company wide purchasing system. To maximize revenues, there has to be a mix of out- patients and in patient care, there will be shorter stays in the future.