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Biomedical subjects

Gail A Wolf

Publications and source records attributed to Gail A Wolf.

7 recordsLinked to original sources

Investment in the future: a 3-level approach for developing the healthcare leaders of tomorrow.

Among the numerous challenges facing healthcare leaders is the paucity of well-prepared, effective managers. Cuts in recent years have reduced "bench strength," and the demands of managing in a complex industry are significant. The authors describe a 3-level leadership development program created at the University of Pittsburgh Medical Center to meet this challenge. Leadership gaps, content for each level, and outcomes are discussed.

Attitude of Health Personnel↗

A road map for creating a Magnet work environment.

OBJECTIVE: The authors examine the relationship between working environment and the developmental level of the workforce, against the backdrop of the American Nurses Credentialing Center Magnet Recognition Program, to provide a road map for creating a positive work environment. BACKGROUND: With the daily demands on nurse managers, there is a need to identify focused strategies to achieve a Magnetized, high-performing work environment. METHODS: The American Nursing Association Magnet survey was administered to nurses at a large healthcare system. Patient units at each hospital were categorized as reactive, responsive, proactive, or high performing. Similar categories of units across all 6 hospitals were analyzed. Analysis of variance was performed on each Force of Magnetism by developmental level. RESULTS: Mean scores measuring the Forces of Magnetism were statistically significant between reactive and responsive units. Likewise, mean scores between responsive and proactive units were also statistically significant. Between reactive and responsive units, there were 3 statistically significant forces of Magnetism: organizational structure, management style, and interdisciplinary relations. These are labeled primary priority forces. Between responsive and proactive units, there were 6 statistically significant forces of Magnetism labeled secondary priority forces: policies and programs; professional models of care; quality of care; consultation and resources; autonomy; and interdisciplinary relations. CONCLUSIONS: Nursing staff perceive the "Magnetism" of the work environment differently, depending on the developmental level of the unit. Nurse managers with reactive units should focus on the 3 Forces of Magnetism identified as the primary priority forces, in order to help develop their unit to the next level of responsive. Once a responsive level has been achieved, the next 6 forces should be addressed.

Data Collection↗

An evidence-based model for enriching academic nursing leadership.

The challenge of developing contemporary nurse leaders for today and tomorrow is compounded not only by the faculty shortage but also by limited faculty expertise in healthcare administration. The authors describe an effective academic-service partnership designed to ground future nursing leaders in the knowledge, skills, and abilities essential for success.

Education, Nursing↗

The transformational model for professional practice: a system integration focus.

Healthcare organizations face the increasingly difficult challenge of providing services that are of high quality, reasonable cost, and easy accessibility for their constituents. Mergers and acquisitions are one strategy for accomplishing this, but in doing so it is critical to have a "road map" to create an integrated system, rather than merely a consortium of hospitals. The University of Pittsburgh Medical Center has successfully created an integrated healthcare system of 19 hospitals. The authors describe the professional practice model used as a framework for success in integrating patient care.

Decision Making↗

Driving improvement in patient care: lessons from Toyota.

Nurses today are attempting to do more with less while grappling with faulty error-prone systems that do not focus on patients at the point of care. This struggle occurs against a backdrop of rising national concern over the incidence of medical errors in healthcare. In an effort to create greater value with scarce resources and fix broken systems that compromise quality care, UPMC Health System is beginning to master and implement the Toyota Production System (TPS)--a method of managing people engaged in work that emphasizes frequent rapid problem solving and work redesign that has become the global archetype for productivity and performance. The authors discuss the rationale for applying TPS to healthcare and implementation of the system through the development of "learning unit" model lines and initial outcomes, such as dramatic reductions in the number of missing medications and thousands of hours and dollars saved as a result of TPS-driven changes. Tracking data further suggest that TPS, with sufficient staff preparation and involvement, has the potential for continuous, lasting, and accelerated improvement in patient care.

Attitude of Health Personnel↗

The impact of staffing on patient outcomes across specialty units.

OBJECTIVE: Determine the relationships between nursing staffing and specific nurse-sensitive outcomes (central line blood-associated infection, pressure ulcer, fall, medication error, and restraint application duration rates) across specialty units (cardiac and noncardiac intensive care, cardiac and noncardiac intermediate care, and medical-surgical). BACKGROUND: A number of hospital-level studies have demonstrated that lower staffing levels are associated with higher adverse patient outcomes. However, insufficient insight into unit-level staffing relationships is available. Further unit-level inquiry is necessary to fully explicate the relationships between staffing and outcomes and to provide assistance to nurse administrators as they seek to develop blueprints for staffing plans that are linked to quality outcomes. METHODS: Secondary analysis of prospective, observational data from 95 patient care units (cardiac intensive care, n = 15; noncardiac intensive care, n = 7; cardiac intermediate care, n = 18; noncardiac intermediate care, n = 12, and medical-surgical, n = 43) across 10 acute care hospitals. RESULTS: No statistically significant relationships were found between central line infection and pressure ulcer rates and staffing across specialty units. Significant inverse relationships were present between staffing and falls in cardiac intensive care, medication errors in both cardiac and noncardiac intensive care units, and restraint rates in the medical-surgical units. CONCLUSIONS: Results from this study suggest that the impact of staffing on outcomes is highly variable across specialty units; however, when present, the relationships are inversely related with lower staffing levels, resulting in higher rates of all outcomes.

Accidental Falls↗

Measuring nurse-sensitive patient outcomes across specialty units.

In efforts to quantify the quality of care delivered to patients within their systems, nursing administrators are being called on to both privately and publicly report nursing-sensitive outcomes for their institutions. Accurate reporting with appropriate patient population or risk adjustment is essential if the reported outcomes are to provide meaningful data to consumers and providers. At present there are no effective mechanisms available that can sufficiently adjust nursing-sensitive outcomes to assure reliable reporting. This study suggests that specialty unit classification may be one method by which nursing-sensitive outcomes can be accurately reported.

Accidental Falls↗