In part 1 of this series, the authors review the evolution of patient classification system (PCS) utilization and describe a third-generation PCS model (3PCS) that focuses on optimizing the patient-caregiver process for the outcomes of cost, health, and caregiver satisfaction. Part 2 (September 1999) will review the implementation of 3 PCS in a large urban hospital. Project rationale, methods for developing and implementing the system, key system components, advantages of the new system, and obstacles to implementation will be presented.

Caregivers↗

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Relationship-centered care: achieving true value in healthcare.

Intuitively, most healthcare leaders and caregivers appreciate the significance of effective relationships and their probable connection with positive patient outcome and financial success. In light of the lack of empirical descriptions and support for these relationships, however, a reluctance is seen to ascribe significant value, energy, and financial resources to relationship building. We describe the national initiative sponsored by the Fetzer Institute to support the Relationship-Centered Care Network, describe a relationship model to gain a greater appreciation of the complexities of relationships, and share experiences of an organization that operates based on the principles of relationship-centered care.

Academies and Institutes↗

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A total healing environment: the Yavapai Regional Medical Center story.

Patient care executives are continually challenged to increase productivity without additional expense or negative effect on patient care quality. Identifying the optimal organizational set of circumstances that meets the needs of all stakeholders is a challenge for even the most dedicated and skilled executive. This article is a case study in which healthcare leaders intuitively believed in a healing environment and successfully implemented the organizational changes necessary to translate the essence of healing into their traditional organization. The experiences of seven executives within the organization provide critical information for organizations considering implementation of a healing model in traditional settings. Characteristics of a healing model, planning and implementation considerations, and the measurement of the outcomes are identified. In addition, the research methodology used to examine the relationship of healing model characteristics to selected organizational outcomes is described.

Arizona↗

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Partnership economics: nursing's challenge in a quantum age.

While the task of ascribing economic value to human caring is incredibly complex, Eisler (1998) reminds us that economic systems can and do change--and all our economic institutions are human creations. Humans can create new economic rules that recognize caring as the most foundational economically productive work (Eisler, 1998). In selected situations, the work of nursing has enormous economic value and new research continues to emerge which support our intuitive beliefs about the economic value of nursing's work (Levinson, Roter, & Frankel, 1997; Revans, 1964; Salmond, 1972). The future of health care requires that this work continues. The value of developing conscious economic inventions for nursing has the potential to assist nursing in its cost-effectiveness analysis, document the economic value of caring behaviors, inspire recruitment, and decrease the number of nurses leaving the profession. Nursing is challenged to shift its consciousness to one that is based on the value equation of quality, cost, and service. We are challenged to recognize the need to build a more equitable and humane economic system that gives real value to the work of caring, and to partner with other health care leaders, policy analysts, and economists in the process. Ultimately, developing economic measurements for the redefined work in nursing will require significant changes in economic measurements, institutions, rules as well as social norms, customs, and laws to quantify those goods not traditionally valued. The focus and energy of the nursing profession must move beyond overwhelming notions of loss and change; to challenging leadership to actively write and produce a better script for health in America beyond what we have developed over the past century. Indeed, this work is the requisite for the profession if what our children receive is the next level of enhancement from that which this generation obtained. It is no longer an option in creating a preferred future, it is nursing's mandate.

Economics, Nursing↗

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Healing models for organizations: description, measurement, and outcomes.

Healthcare leaders are continually searching for ways to improve their ability to provide optimal healthcare services, be financially viable, and retain quality caregivers, often feeling like such goals are impossible to achieve in today's intensely competitive environment. Many healthcare leaders intuitively recognize the need for more humanistic models and the probable connection with positive patient outcomes and financial success but are hesitant to make significant changes in their organizations because of the lack of model descriptions or documented recognition of the clinical and financial advantages of humanistic models. This article describes a study that was developed in response to the increasing work in humanistic or healing environment models and the need for validation of the advantages of such models. The healthy organization model, a framework for healthcare organizations that incorporates humanistic healing values within the traditional structure, is presented as a result of the study. This model addresses the importance of optimal clinical services, financial performance, and staff satisfaction. The five research-based organizational components that form the framework are described, and key indicators of organizational effectiveness over a five-year period are presented. The resulting empirical data are strongly supportive of the healing model and reflect positive outcomes for the organization.

Arizona↗

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Nursing partnerships: education and practice.

Explore the source record for details and available documents.

Curriculum↗