Biomedical subjects

K S Hitchings

Publications and source records attributed to K S Hitchings.

At least 19 recordsLinked to original sources

PubMed1998

Measuring and evaluating hospital restructuring efforts. Eighteen-month follow-up and extension to critical care, Part 1.

Increasingly, hospital restructuring is viewed with skepticism because of a lack of systematic and rigorous evaluation of its impact on quality of care. This first article in a two-part series describes comprehensive evaluation of the effects of hospital restructuring on patient satisfaction, nurse satisfaction, costs of care, and clinical quality on four medical-surgical units at a large tertiary hospital. In addition, early application of the model to critical care is described. A quasiexperimental pre- and post-design combined with concurrent control units for selected measures was the overall strategy. The authors conclude that comprehensive restructuring of hospital-based care can take place in a manner that preserves multiple dimensions of quality while decreasing costs. This only can be ascertained, however, through rigorous and systematic measurement and evaluation. Part 2 will detail application and evaluation of the restructuring model in the critical care environment.

Critical Care↗

PubMed1998

Measuring and evaluating hospital restructuring efforts: 18-month follow-up and extension to critical care, Part 2.

Critical care has enjoyed unobstructed growth during the past two decades; however, to remain viable, process and role changes are pivotal to ensuring continued quality, cost-effective, and efficient care. In this article, the second in a two-part series, the authors describe restructuring efforts, inclusive of their measurement and evaluation strategies, within four critical care units at an acute care, tertiary institution. Special emphasis is placed on the process, the authors' observations, and lessons learned to date. Part 1 (September 1998) presented evaluation data of the effects of hospital restructuring on patient and nurse satisfaction, costs of care, and clinical quality in four medical-surgical units.

Critical Care↗

PubMed1998

Measuring critical care redesign: impact on satisfaction and quality.

This report describes restructuring on four critical care units at an acute, tertiary care hospital in South-east Pennsylvania. Utilizing a Patient Centered Care conceptual framework that had been successfully applied in the medical-surgical areas, restructuring involved three main areas: revamping of work processes, inclusive of redesigned staff roles; environmental and facility changes; and enhancement of telecommunication and information systems. Preliminary analyses six months post redesign revealed improvements and maintenance in four outcomes areas--satisfaction, quality and efficiency, and costs of care.

Critical Care↗

PubMed1998

The evaluation of hospital restructuring efforts: satisfaction, quality, and costs.

This article reports on study evaluating the effects of hospital restructuring on patient satisfaction, nurse satisfaction, cost of care, and clinical quality. The restructuring involved facility redesign, telecommunications enhancement, and implementation of patient care processes incorporating multiskilled personnel and case facilitation systems. The results indicate improved patient and nurse satisfaction, decreased length of stay and variable cost per patient day, and good clinical outcomes.

Hospital Bed Capacity, 500 and over↗

PubMed1995

Spend a day with a nurse.

Explore the source record for details and available documents.

Humans↗

PubMed1994

A professional development model to foster change.

This article proposes that professional development be a core principle within an organization to equip staff members with the resources to adapt to change. Multiple examples of professional development activities are identified. Four absolutes to create an environment to support professional development are discussed. A successful professional development model at Lehigh Valley Hospital, Allentown, PA, is detailed, including examples of funding sources. Finally, the investigators furnish examples of how an environment rich in professional development activities fosters staff members' abilities to cope with change.

Humans↗

PubMedDate not supplied

A pragmatic approach to measuring and evaluating hospital restructuring efforts.

Organizations have expended enormous resources to restructure care delivery Despite the growing literature describing these organizational innovations there is a paucity of credible data that reflects systematic measurement and evaluation of such changes. This report not only describes a comprehensive research based restructuring effort in a 720 bed acute care hospital, but it also describes an outcomes evaluation strategy and associated findings that may serve as a model and a guide for other healthcare institutions.

Hospital Restructuring↗

PubMedDate not supplied

Respiratory nursing diagnoses: practicing nurses' selection of defining characteristics.

One-hundred medical/surgical nurses from two hospitals participated in a study designed to determine which defining characteristics professional nurses working in acute-care settings associated with each of the three respiratory nursing diagnoses identified by the North American Nursing Diagnosis Association (NANDA). All NANDA defining characteristics for impaired gas exchange and ineffective airway clearance were selected by at least 63% and 67% of the study participants, respectively. Thirteen of the 15 NANDA defining characteristics for ineffective breathing pattern were selected by at least 68% of the study participants. Two characteristics of ineffective breathing pattern identified by NANDA, cough and fremitus, were selected by only 47% and 45% of respondents. This study was the first in a series of studies intended to validate the respiratory nursing diagnoses.

Adult↗

PubMedDate not supplied

Preceptors promote competence and retention: strategies to achieve success.

When considering factors that affect nurse recruitment and retention, an appropriate response to the nursing shortage may be to either implement a preceptor model or refine an existing preceptor program. This article describes the evolution of a comprehensive preceptor model including the following: strategies to gain staff, administrative, and educational support and involvement; a preceptorship policy and procedure; a formal program to prepare preceptors; the need for identified orientation, learning expectations, and documentation of the same; evaluation methods of a preceptor model; and rewards for the preceptor. The viability and strength of this preceptor program may be attributed to the inclusion of all levels of nursing staff in its development and implementation.

Clinical Competence↗

PubMedDate not supplied