While the battle over nurse staffing levels rages nationwide, some hospitals are figuring out ways to do more with less. By concentrating on increasing efficiency, they say they are able to increase patient andÂ employee satisfaction without adding additional staff. Some nurses, however, aren’t so sure that factory-born continuous performance improvement (CPI) efforts have a place in healthcare.
“The essence of nursing is much more than a sum of the parts you can observe and write down on a wall full of sticky notes,’ Nellie Munn, RN, a Minnesota-based nurse told The New York Times.
Most nurses support the idea of improving work flow — who wants to spend 20 minutes tracking down a portable commode? — but become leery when they sense the improvements are being made in an effort to trim staff or to increase the number of patients in a nurse’s caseload. Many of the so-called improvements, such as stashing commonly used supplies in or near patient rooms and using whiteboards to facilitate in-room communication, have actually been around for years.
But while nurses are wary of changes that they believe may negatively affect staffing or patient safety, most welcome opportunities to reduce redundancies that take them away from their patients. One recent study, for instance, quantified the amount of time nurses and other clinicians spend waiting to log onto electronic healthcare records. Quality improvement efforts devoted to decreasing log-in times would increase the amount of time available for patient care.
Currently, nurses only spend about 20 to 35 percent of their time in direct patient care. The Transforming Care at the Bedside program, an initiative of the Robert Wood Johnson Foundation and the Institute for Healthcare Improvement, aims to increase that time to 70 percent.
What steps is your hospital or healthcare facility taking to improve efficiency? Do you think the changes help or hinder nurses?