This document discusses the pros and cons of 8-hour and 12-hour shifts for staff in long-term care settings. Some benefits of 8-hour shifts mentioned are shorter work hours, more time for other activities, and higher patient satisfaction. However, there are more shift changes which means less continuity of care and more faces for patients to learn. Potential issues with 12-hour shifts include increased risks of fatigue, stress, burnout and medical errors due to longer hours. However, 12-hour shifts also allow for a shorter work week and better continuity of care. The document examines different studies on this issue but does not come to a clear conclusion.
24 Hour Shift Background
• The 24 Hour Shift method of working is utilized by about
190,000 of the more than 250,000 professional full time
Firefighters, EMTs and Paramedics in the IAFF in North
America.
• In some American jurisdictions, there is no mandatory
This document provides information on using data and charts in healthcare quality improvement work, specifically in a Six Sigma framework. It discusses types of charts like run charts and control charts and how they are used to analyze different types of variation in processes over time. Examples are given of charts created from real healthcare data on topics like patient diagnoses, IV fluid administration, and intracranial pressure during a quality improvement project. The document emphasizes how charts can help teams determine if a process is stable or if changes have resulted in improvement.
Select our performance review PowerPoint Presentation slide to highlight key features of your business and its functioning. You can easily demonstrate your thoughts and ideas with our visually impressive PowerPoint design. Make use of this professionally designed performance review PPT template to shape up your knowledge and experience about the performance of your employees. This performance review PowerPoint deck has been designed with all the important aspects related to performance review such as evaluation criteria, 360-degree performance appraisal, guidelines for feedback, employee rating summary, performance measures, etc. Performance reviews allow you and the employee to clearly see how he or she is improving compared with earlier reviews. This review also shows whether an employee is ready to assume more responsibility. Our performance review PowerPoint slides highlight skill deficiencies and clearly point to where a staff member could use additional training. Showcase your aspects with this ready-to-use performance review PowerPoint template. Our Performance Review PowerPoint Presentation Slides are a good investment. A high degree of interest is guaranteed.
Lean Six Sigma applications in healthcare require an understanding of how the tools and methodologies translate to the people-intensive processes of patient care. Once applied, the possibilities are endless. Using real-world examples of the most common types of errors in clinical services, participants will learn how the DMAIC structure within Lean Six Sigma will lead them to solutions that will prevent future errors.
This document discusses the FOCUS-PDCA methodology for continuous process improvement. It describes the FOCUS steps as finding a process for improvement, organizing a team, clarifying the current process, understanding causes of variation, and selecting potential improvements. The PDCA cycle is then described as planning an improvement, doing it, checking the results, and acting to hold gains or continue improving. Cause-and-effect diagrams are introduced as a tool to determine major categories of influences on a process. The document provides detailed questions to consider for each step of the FOCUS methodology and each phase of the PDCA cycle to systematically improve processes.
Implementation of quality improvement program in hospitalsLallu Joseph
A quality improvement program in hospitals aims to continuously monitor and improve quality through systematic activities organized by the hospital. The document outlines the steps to implement a quality improvement program which includes selecting a quality improvement project, assembling a team, developing aim and measure statements, identifying change ideas by analyzing current processes, testing changes, and sustaining improvements. The goal is to improve patient outcomes, clinical and managerial processes, and safety through engaging staff and using a systematic approach of planning, testing, and measuring changes.
The document discusses the key functions and design considerations for a hospital mortuary. It notes that a mortuary is important for preserving bodies for forensic investigation and allowing identification. Key areas of a mortuary include storage chambers, an autopsy room treated like an operating theater, facilities for handling bodies, and administrative spaces. Design priorities include ventilation, drainage, and segregation from patient areas. The mortuary aims to respectfully care for the deceased while facilitating medical examination and handling until final disposal.
The document discusses the roles and responsibilities of nursing services in a hospital. It outlines the organization of nursing which focuses on patient care and education. Nursing services are categorized into nursing care, administration, and education. The roles involve ensuring quality care, staff management, monitoring performance, and maintaining standards. Different nursing approaches and methods like functional, team, and patient care are explained.
24 Hour Shift Background
• The 24 Hour Shift method of working is utilized by about
190,000 of the more than 250,000 professional full time
Firefighters, EMTs and Paramedics in the IAFF in North
America.
• In some American jurisdictions, there is no mandatory
This document provides information on using data and charts in healthcare quality improvement work, specifically in a Six Sigma framework. It discusses types of charts like run charts and control charts and how they are used to analyze different types of variation in processes over time. Examples are given of charts created from real healthcare data on topics like patient diagnoses, IV fluid administration, and intracranial pressure during a quality improvement project. The document emphasizes how charts can help teams determine if a process is stable or if changes have resulted in improvement.
Select our performance review PowerPoint Presentation slide to highlight key features of your business and its functioning. You can easily demonstrate your thoughts and ideas with our visually impressive PowerPoint design. Make use of this professionally designed performance review PPT template to shape up your knowledge and experience about the performance of your employees. This performance review PowerPoint deck has been designed with all the important aspects related to performance review such as evaluation criteria, 360-degree performance appraisal, guidelines for feedback, employee rating summary, performance measures, etc. Performance reviews allow you and the employee to clearly see how he or she is improving compared with earlier reviews. This review also shows whether an employee is ready to assume more responsibility. Our performance review PowerPoint slides highlight skill deficiencies and clearly point to where a staff member could use additional training. Showcase your aspects with this ready-to-use performance review PowerPoint template. Our Performance Review PowerPoint Presentation Slides are a good investment. A high degree of interest is guaranteed.
Lean Six Sigma applications in healthcare require an understanding of how the tools and methodologies translate to the people-intensive processes of patient care. Once applied, the possibilities are endless. Using real-world examples of the most common types of errors in clinical services, participants will learn how the DMAIC structure within Lean Six Sigma will lead them to solutions that will prevent future errors.
This document discusses the FOCUS-PDCA methodology for continuous process improvement. It describes the FOCUS steps as finding a process for improvement, organizing a team, clarifying the current process, understanding causes of variation, and selecting potential improvements. The PDCA cycle is then described as planning an improvement, doing it, checking the results, and acting to hold gains or continue improving. Cause-and-effect diagrams are introduced as a tool to determine major categories of influences on a process. The document provides detailed questions to consider for each step of the FOCUS methodology and each phase of the PDCA cycle to systematically improve processes.
Implementation of quality improvement program in hospitalsLallu Joseph
A quality improvement program in hospitals aims to continuously monitor and improve quality through systematic activities organized by the hospital. The document outlines the steps to implement a quality improvement program which includes selecting a quality improvement project, assembling a team, developing aim and measure statements, identifying change ideas by analyzing current processes, testing changes, and sustaining improvements. The goal is to improve patient outcomes, clinical and managerial processes, and safety through engaging staff and using a systematic approach of planning, testing, and measuring changes.
The document discusses the key functions and design considerations for a hospital mortuary. It notes that a mortuary is important for preserving bodies for forensic investigation and allowing identification. Key areas of a mortuary include storage chambers, an autopsy room treated like an operating theater, facilities for handling bodies, and administrative spaces. Design priorities include ventilation, drainage, and segregation from patient areas. The mortuary aims to respectfully care for the deceased while facilitating medical examination and handling until final disposal.
The document discusses the roles and responsibilities of nursing services in a hospital. It outlines the organization of nursing which focuses on patient care and education. Nursing services are categorized into nursing care, administration, and education. The roles involve ensuring quality care, staff management, monitoring performance, and maintaining standards. Different nursing approaches and methods like functional, team, and patient care are explained.
This document summarizes research on the relationship between nurse staffing levels and patient outcomes. It identifies several influential studies that found associations between higher nurse staffing levels and lower mortality rates, failure to rescue rates, and nosocomial infection rates. The document also discusses different approaches to establishing minimum nurse staffing standards and ratios. It concludes that simply requiring more nurses may not improve patient care without also enhancing working conditions and support for nurses.
This document discusses outpatient departments (OPDs) in hospitals. It defines an OPD as the department of a hospital that provides care to non-inpatients on an outpatient basis. The document outlines the objectives, history, and types of OPDs. It describes the facilities and process of an OPD visit. Common problems at OPDs are identified such as long wait times and staffing shortages. Suggestions are provided to address issues like managing patient queues and improving record keeping.
The document discusses NABH Nursing Excellence Standards presented by a Nursing Officer. It covers the vision and scope of NABH, which includes accreditation of healthcare facilities and quality promotion initiatives. Nursing excellence is measured according to 7 standards including nursing resource management, nursing care of patients, management of medication, education/communication, infection control, empowerment/governance, and quality indicators. Key aspects of nursing resource management standards are ensuring adequate staffing levels and ratios according to workload, induction and continuous training of nursing staff, performance management processes, and workplace safety.
Creek View Elementary School outlines procedures for preparing for a natural disaster. The document details training staff, students, and parents on evacuation procedures and communication methods during an event. It also establishes protocols for search and rescue teams, first aid, student supervision, triage care, and student release to ensure student safety and accountability in the event of a natural disaster.
This document discusses staffing and scheduling in nursing management. It provides information on determining staffing needs based on patient acuity levels and calculating the number of nurses required. The document categorizes patients into four levels of care based on nursing hours needed per day. It demonstrates how to assess nursing hours required per shift and allocate nurses to units based on patient numbers and care needs. The objectives of effective staffing and criteria for scheduling such as coverage, quality, stability and flexibility are also mentioned.
The document provides an agenda and overview for an e-seminar on process mapping. It discusses what process mapping is, how to create current and future state maps, common tools and techniques used in mapping, and how to analyze and improve maps. The goal of process mapping is to identify opportunities to streamline workflows and eliminate waste and inefficiencies in order to improve processes and services.
Introduction to Continous Quality ImprovementGina Ingrouille
This document provides an agenda and overview for a training on continuous quality improvement. The training will cover topics such as what accreditation and CQI are, why they are important, how to engage in the PDCA model of change, using policies and procedures, and reviewing health and community service standards. Participants will have exercises to practice applying CQI concepts and evaluating their organization's processes. They will also learn how to find information in policies and procedures. The goal is to help organizations demonstrate CQI and prepare for accreditation.
Hospital hazards can endanger infrastructure, staff, and patients. They include biological, chemical, physical, ergonomic, and psychological risks. Biological hazards include infectious diseases from needle sticks or caring for contagious patients. Chemical hazards involve mercury spills or radiation exposure. Physical hazards consist of falls, fires, extreme temperatures, or violent incidents. Ergonomic hazards cause musculoskeletal injuries from lifting or repetitive motions. Psychological hazards lead to stress, burnout, or trauma from patient deaths. Hospitals must implement training, protective equipment, hazard communication programs, and other controls to manage these risks and protect safety.
This document provides information about disaster management in hospitals. It begins with an introduction to disaster management, defining key terms like disaster, management, and disaster management. It then discusses the phases of disaster management and outlines disaster action plans, management plans, and relevant acts. It also covers hospital disaster plans and committees. The document discusses various types of disasters and provides examples of recent hospital disasters in India. It emphasizes the importance of disaster preparedness and provides guidelines for various emergency responses, including to fires and floods.
The document discusses outpatient departments (OPDs) in hospitals. It defines an OPD and provides reasons for their establishment, including rising healthcare costs and limited hospital beds. OPDs provide about 30-35% of hospital revenue. Key points made include:
- OPDs see over 50% of inpatients and act as screening points for treatment need. On average, 500 outpatients are seen per hospital bed per year.
- Common problems faced by OPDs include insufficient doctors and facilities, long wait times, and lack of privacy. Queuing theory principles and appointment systems can help minimize wait times.
- Proper design, staffing, equipment and management of patient flow are needed to improve OPD efficiency
The document provides information about staffing philosophy, norms, and methods for estimating nursing staff requirements. It discusses various committees that have established nursing staff norms in India, including the Staff Inspection Unit, Bajaj Committee, High Power Committee, and Indian Nursing Council. It also outlines a patient classification system that assigns patients to levels of care in order to calculate nursing staff needs based on the required hours of care per patient. Formulas are provided for determining the number of nursing staff needed per 24-hour period and shift based on patient classifications.
A Key Performance Indicator (KPI) is a measurable value that demonstrates how effectively a company is achieving key business objectives. Organizations use key performance indicators at multiple levels to evaluate their success at reaching targets
OPD is the mirror of the hospital, which reflects the functioning of the hospital being the first point of contact between the patient and the hospital staff.
Patients visit the OPD for various purposes, like consultation, day care treatment, investigation, referral, admission and post discharge follow up. Not only for treatment but also for preventing and promotive services like, health check up, Immunisation, Physio-therapy and so on.
This document provides information about staff development training at Fatima Hospital in Mau. It discusses types of hospitals including small, medium, and large hospitals based on bed capacity. It also defines nursing as protecting health, preventing illness, and treating patients. The document lists many types of nurses and their roles. It outlines responsibilities for Fatima Hospital staff including safety, hygiene, cooperation, and reporting issues. Responsibilities of staff nurses are also detailed such as patient care, inventory, handovers, assessments, documentation and more.
The document discusses 360 degree and 180 degree performance appraisal systems. A 180 degree appraisal allows feedback from team members to be provided to the line manager during an individual's performance discussion. A 360 degree appraisal involves collecting feedback about an individual from their line manager, colleagues, and direct reports. Key points about JSPL's performance review system are that it uses a rating scale method and management by objectives approach. Performance is reviewed annually with mid-year reviews for those seeking promotions. Feedback and discussion between employees and their managers are important parts of the process.
This document defines and discusses various types of hospital statistics that are used to evaluate hospital performance and quality of care. It describes statistics related to beds, admissions, discharges, deaths, workloads, care evaluation, and population served. Key metrics discussed include bed occupancy rate, average length of stay, turnover interval, gross and net death rates, autopsy rate, and caesarean section rate. Hospital statistics provide important information for planning, resource allocation, and identifying areas for improvement in hospital administration and services.
Waste is any step or action in a process that is not required to complete a process. The 8 Wastes are: Defects, Overproduction, Waiting, Non-Utilized Talent, Transportation, Inventory, Motion, Extra-Processing otherwise known as acronym, DOWNTIME.
https://goleansixsigma.com/8-wastes/
Tools and Techniques for Quality ManagementNazrul Islam
The tools and techniques most commonly used in Quality management and process improvement are: Cause and effect diagram. Control Charts. Histogram. Pareto Charts.
Organization and Management of the Emergency Room of a HospitalReynaldo Joson
The document discusses the organization and management of a hospital emergency department. It describes the purpose of the emergency department as providing emergency medical services 24/7 to patients without prior appointment. It outlines the general functions as catering to patients needing emergency care and providing emergency medical services. Specific functions include services like resuscitation, assessment, treatment, and referral. The goal is to provide integrated value-based services through systems like quality management, risk management, and records management. Key performance indicators ensure financial viability, maximal service utilization, excellent clinical outcomes, and positive patient feedback.
This document discusses the debate around nurses working 12-hour shifts versus 8-hour shifts. Research is being conducted to understand the impact of shift length on staff, patient safety, and job satisfaction. Some nurses prefer 12-hour shifts for more days off, while others argue it can affect quality of care. The goal is for employers to offer a choice between 8- and 12-hour shifts to increase job satisfaction and reduce fatigue, while balancing staffing needs. A survey was conducted to evaluate readiness for implementing a choice in shift lengths.
The document discusses various aspects of electronic medical records (EMRs) and their implementation. EMRs can help reduce medical errors, improve patient-physician interaction, and make patient charts easier to access. However, EMR implementation also faces challenges like system crashes, security breaches, decreased initial physician productivity due to training needs, and resistance to change. Overall, while EMRs provide benefits like improved billing accuracy and payment speed, their adoption involves significant costs, training requirements, and workflow adjustments.
This document summarizes research on the relationship between nurse staffing levels and patient outcomes. It identifies several influential studies that found associations between higher nurse staffing levels and lower mortality rates, failure to rescue rates, and nosocomial infection rates. The document also discusses different approaches to establishing minimum nurse staffing standards and ratios. It concludes that simply requiring more nurses may not improve patient care without also enhancing working conditions and support for nurses.
This document discusses outpatient departments (OPDs) in hospitals. It defines an OPD as the department of a hospital that provides care to non-inpatients on an outpatient basis. The document outlines the objectives, history, and types of OPDs. It describes the facilities and process of an OPD visit. Common problems at OPDs are identified such as long wait times and staffing shortages. Suggestions are provided to address issues like managing patient queues and improving record keeping.
The document discusses NABH Nursing Excellence Standards presented by a Nursing Officer. It covers the vision and scope of NABH, which includes accreditation of healthcare facilities and quality promotion initiatives. Nursing excellence is measured according to 7 standards including nursing resource management, nursing care of patients, management of medication, education/communication, infection control, empowerment/governance, and quality indicators. Key aspects of nursing resource management standards are ensuring adequate staffing levels and ratios according to workload, induction and continuous training of nursing staff, performance management processes, and workplace safety.
Creek View Elementary School outlines procedures for preparing for a natural disaster. The document details training staff, students, and parents on evacuation procedures and communication methods during an event. It also establishes protocols for search and rescue teams, first aid, student supervision, triage care, and student release to ensure student safety and accountability in the event of a natural disaster.
This document discusses staffing and scheduling in nursing management. It provides information on determining staffing needs based on patient acuity levels and calculating the number of nurses required. The document categorizes patients into four levels of care based on nursing hours needed per day. It demonstrates how to assess nursing hours required per shift and allocate nurses to units based on patient numbers and care needs. The objectives of effective staffing and criteria for scheduling such as coverage, quality, stability and flexibility are also mentioned.
The document provides an agenda and overview for an e-seminar on process mapping. It discusses what process mapping is, how to create current and future state maps, common tools and techniques used in mapping, and how to analyze and improve maps. The goal of process mapping is to identify opportunities to streamline workflows and eliminate waste and inefficiencies in order to improve processes and services.
Introduction to Continous Quality ImprovementGina Ingrouille
This document provides an agenda and overview for a training on continuous quality improvement. The training will cover topics such as what accreditation and CQI are, why they are important, how to engage in the PDCA model of change, using policies and procedures, and reviewing health and community service standards. Participants will have exercises to practice applying CQI concepts and evaluating their organization's processes. They will also learn how to find information in policies and procedures. The goal is to help organizations demonstrate CQI and prepare for accreditation.
Hospital hazards can endanger infrastructure, staff, and patients. They include biological, chemical, physical, ergonomic, and psychological risks. Biological hazards include infectious diseases from needle sticks or caring for contagious patients. Chemical hazards involve mercury spills or radiation exposure. Physical hazards consist of falls, fires, extreme temperatures, or violent incidents. Ergonomic hazards cause musculoskeletal injuries from lifting or repetitive motions. Psychological hazards lead to stress, burnout, or trauma from patient deaths. Hospitals must implement training, protective equipment, hazard communication programs, and other controls to manage these risks and protect safety.
This document provides information about disaster management in hospitals. It begins with an introduction to disaster management, defining key terms like disaster, management, and disaster management. It then discusses the phases of disaster management and outlines disaster action plans, management plans, and relevant acts. It also covers hospital disaster plans and committees. The document discusses various types of disasters and provides examples of recent hospital disasters in India. It emphasizes the importance of disaster preparedness and provides guidelines for various emergency responses, including to fires and floods.
The document discusses outpatient departments (OPDs) in hospitals. It defines an OPD and provides reasons for their establishment, including rising healthcare costs and limited hospital beds. OPDs provide about 30-35% of hospital revenue. Key points made include:
- OPDs see over 50% of inpatients and act as screening points for treatment need. On average, 500 outpatients are seen per hospital bed per year.
- Common problems faced by OPDs include insufficient doctors and facilities, long wait times, and lack of privacy. Queuing theory principles and appointment systems can help minimize wait times.
- Proper design, staffing, equipment and management of patient flow are needed to improve OPD efficiency
The document provides information about staffing philosophy, norms, and methods for estimating nursing staff requirements. It discusses various committees that have established nursing staff norms in India, including the Staff Inspection Unit, Bajaj Committee, High Power Committee, and Indian Nursing Council. It also outlines a patient classification system that assigns patients to levels of care in order to calculate nursing staff needs based on the required hours of care per patient. Formulas are provided for determining the number of nursing staff needed per 24-hour period and shift based on patient classifications.
A Key Performance Indicator (KPI) is a measurable value that demonstrates how effectively a company is achieving key business objectives. Organizations use key performance indicators at multiple levels to evaluate their success at reaching targets
OPD is the mirror of the hospital, which reflects the functioning of the hospital being the first point of contact between the patient and the hospital staff.
Patients visit the OPD for various purposes, like consultation, day care treatment, investigation, referral, admission and post discharge follow up. Not only for treatment but also for preventing and promotive services like, health check up, Immunisation, Physio-therapy and so on.
This document provides information about staff development training at Fatima Hospital in Mau. It discusses types of hospitals including small, medium, and large hospitals based on bed capacity. It also defines nursing as protecting health, preventing illness, and treating patients. The document lists many types of nurses and their roles. It outlines responsibilities for Fatima Hospital staff including safety, hygiene, cooperation, and reporting issues. Responsibilities of staff nurses are also detailed such as patient care, inventory, handovers, assessments, documentation and more.
The document discusses 360 degree and 180 degree performance appraisal systems. A 180 degree appraisal allows feedback from team members to be provided to the line manager during an individual's performance discussion. A 360 degree appraisal involves collecting feedback about an individual from their line manager, colleagues, and direct reports. Key points about JSPL's performance review system are that it uses a rating scale method and management by objectives approach. Performance is reviewed annually with mid-year reviews for those seeking promotions. Feedback and discussion between employees and their managers are important parts of the process.
This document defines and discusses various types of hospital statistics that are used to evaluate hospital performance and quality of care. It describes statistics related to beds, admissions, discharges, deaths, workloads, care evaluation, and population served. Key metrics discussed include bed occupancy rate, average length of stay, turnover interval, gross and net death rates, autopsy rate, and caesarean section rate. Hospital statistics provide important information for planning, resource allocation, and identifying areas for improvement in hospital administration and services.
Waste is any step or action in a process that is not required to complete a process. The 8 Wastes are: Defects, Overproduction, Waiting, Non-Utilized Talent, Transportation, Inventory, Motion, Extra-Processing otherwise known as acronym, DOWNTIME.
https://goleansixsigma.com/8-wastes/
Tools and Techniques for Quality ManagementNazrul Islam
The tools and techniques most commonly used in Quality management and process improvement are: Cause and effect diagram. Control Charts. Histogram. Pareto Charts.
Organization and Management of the Emergency Room of a HospitalReynaldo Joson
The document discusses the organization and management of a hospital emergency department. It describes the purpose of the emergency department as providing emergency medical services 24/7 to patients without prior appointment. It outlines the general functions as catering to patients needing emergency care and providing emergency medical services. Specific functions include services like resuscitation, assessment, treatment, and referral. The goal is to provide integrated value-based services through systems like quality management, risk management, and records management. Key performance indicators ensure financial viability, maximal service utilization, excellent clinical outcomes, and positive patient feedback.
This document discusses the debate around nurses working 12-hour shifts versus 8-hour shifts. Research is being conducted to understand the impact of shift length on staff, patient safety, and job satisfaction. Some nurses prefer 12-hour shifts for more days off, while others argue it can affect quality of care. The goal is for employers to offer a choice between 8- and 12-hour shifts to increase job satisfaction and reduce fatigue, while balancing staffing needs. A survey was conducted to evaluate readiness for implementing a choice in shift lengths.
The document discusses various aspects of electronic medical records (EMRs) and their implementation. EMRs can help reduce medical errors, improve patient-physician interaction, and make patient charts easier to access. However, EMR implementation also faces challenges like system crashes, security breaches, decreased initial physician productivity due to training needs, and resistance to change. Overall, while EMRs provide benefits like improved billing accuracy and payment speed, their adoption involves significant costs, training requirements, and workflow adjustments.
1212016 Health Care Tips and Advice Practicing Patience at .docxhyacinthshackley2629
12/1/2016 Health Care Tips and Advice: Practicing Patience at the Doctors' Office - WSJ
http://www.wsj.com/articles/SB10001424052702304410504575560081847852618 1/5
Of all the problems with the U.S. health-care system, one of the most vexing for patients
is simply sitting in the doctor's waiting room. Being ushered into the exam room, only to
be left shivering in a paper gown, to wait some more, adds to the aggravation. It's the
health-care equivalent of being stuck on the tarmac in a crowded plane.
The average time
patients spend
waiting to see a
health-care
provider is 22
minutes, and some
waits stretch for
hours, according to
a 2009 report by
Press Ganey
Associates, a
health-care
consulting firm,
which surveyed 2.4
million patients at more than 10,000 locations. Orthopedists have the longest waits, at
29 minutes; dermatologists the shortest, at 20. The report also noted that patient
satisfaction dropped significantly with each five minutes of waiting time.
Physicians rightly bristle that they aren't serving french fries. Patients are different, and
their needs are unpredictable. What's more, doctors say that fee-for-service medicine
with low reimbursement rates forces them to keep packing more patients into each day,
compounding the opportunity for delays.
"I live my life in seven-minute intervals," says Laurie Green, a obstetrician-gynecologist
in San Francisco who delivers 400 to 500 babies a year and says she needs to bring in $70
every 15 minutes just to meet her office overhead.
This copy is for your personal, noncommercial use only. To order presentationready copies for distribution to your colleagues, clients or customers visit
http://www.djreprints.com.
http://www.wsj.com/articles/SB10001424052702304410504575560081847852618
HEALTH JOURNAL
Updated Oct. 18, 2010 12:01 a.m. ET
By
MELINDA BECK
Some hospitals, like this one in Virginia, post ER wait times on billboards. ASSOCIATED PRESS
12/1/2016 Health Care Tips and Advice: Practicing Patience at the Doctors' Office - WSJ
http://www.wsj.com/articles/SB10001424052702304410504575560081847852618 2/5
Some practices, like Dr. Green's, pride
themselves on running efficiently, and others
are finding ways to streamline office-traffic
flow and cut waiting time. "Patients' time is
valuable. I think practitioners understand
that more and more," says Andre W. Renna,
executive director of a group of 14
gastroenterologists in Lancaster, Pa. He says
even the term "waiting room" has a bad
connotation. Many offices prefer "reception
area" instead.
Some steps to reduce patient wait times are as simple as leaving a few "catch-up" slots
empty each day or stocking the same supplies in the same place in every exam room.
"That way, doctors don't have to stick their heads out the door and ask where things are.
It saves a lot of time," says L. Gordon Moore, a family physician and faculty member of
the Institute for Healthcare Improvement, a Cambridge, Mass.-based non-.
1212016 Health Care Tips and Advice Practicing Patience at .docxaulasnilda
12/1/2016 Health Care Tips and Advice: Practicing Patience at the Doctors' Office - WSJ
http://www.wsj.com/articles/SB10001424052702304410504575560081847852618 1/5
Of all the problems with the U.S. health-care system, one of the most vexing for patients
is simply sitting in the doctor's waiting room. Being ushered into the exam room, only to
be left shivering in a paper gown, to wait some more, adds to the aggravation. It's the
health-care equivalent of being stuck on the tarmac in a crowded plane.
The average time
patients spend
waiting to see a
health-care
provider is 22
minutes, and some
waits stretch for
hours, according to
a 2009 report by
Press Ganey
Associates, a
health-care
consulting firm,
which surveyed 2.4
million patients at more than 10,000 locations. Orthopedists have the longest waits, at
29 minutes; dermatologists the shortest, at 20. The report also noted that patient
satisfaction dropped significantly with each five minutes of waiting time.
Physicians rightly bristle that they aren't serving french fries. Patients are different, and
their needs are unpredictable. What's more, doctors say that fee-for-service medicine
with low reimbursement rates forces them to keep packing more patients into each day,
compounding the opportunity for delays.
"I live my life in seven-minute intervals," says Laurie Green, a obstetrician-gynecologist
in San Francisco who delivers 400 to 500 babies a year and says she needs to bring in $70
every 15 minutes just to meet her office overhead.
This copy is for your personal, noncommercial use only. To order presentationready copies for distribution to your colleagues, clients or customers visit
http://www.djreprints.com.
http://www.wsj.com/articles/SB10001424052702304410504575560081847852618
HEALTH JOURNAL
Updated Oct. 18, 2010 12:01 a.m. ET
By
MELINDA BECK
Some hospitals, like this one in Virginia, post ER wait times on billboards. ASSOCIATED PRESS
12/1/2016 Health Care Tips and Advice: Practicing Patience at the Doctors' Office - WSJ
http://www.wsj.com/articles/SB10001424052702304410504575560081847852618 2/5
Some practices, like Dr. Green's, pride
themselves on running efficiently, and others
are finding ways to streamline office-traffic
flow and cut waiting time. "Patients' time is
valuable. I think practitioners understand
that more and more," says Andre W. Renna,
executive director of a group of 14
gastroenterologists in Lancaster, Pa. He says
even the term "waiting room" has a bad
connotation. Many offices prefer "reception
area" instead.
Some steps to reduce patient wait times are as simple as leaving a few "catch-up" slots
empty each day or stocking the same supplies in the same place in every exam room.
"That way, doctors don't have to stick their heads out the door and ask where things are.
It saves a lot of time," says L. Gordon Moore, a family physician and faculty member of
the Institute for Healthcare Improvement, a Cambridge, Mass.-based non- ...
1212016 Health Care Tips and Advice Practicing Patience at .docxnovabroom
12/1/2016 Health Care Tips and Advice: Practicing Patience at the Doctors' Office - WSJ
http://www.wsj.com/articles/SB10001424052702304410504575560081847852618 1/5
Of all the problems with the U.S. health-care system, one of the most vexing for patients
is simply sitting in the doctor's waiting room. Being ushered into the exam room, only to
be left shivering in a paper gown, to wait some more, adds to the aggravation. It's the
health-care equivalent of being stuck on the tarmac in a crowded plane.
The average time
patients spend
waiting to see a
health-care
provider is 22
minutes, and some
waits stretch for
hours, according to
a 2009 report by
Press Ganey
Associates, a
health-care
consulting firm,
which surveyed 2.4
million patients at more than 10,000 locations. Orthopedists have the longest waits, at
29 minutes; dermatologists the shortest, at 20. The report also noted that patient
satisfaction dropped significantly with each five minutes of waiting time.
Physicians rightly bristle that they aren't serving french fries. Patients are different, and
their needs are unpredictable. What's more, doctors say that fee-for-service medicine
with low reimbursement rates forces them to keep packing more patients into each day,
compounding the opportunity for delays.
"I live my life in seven-minute intervals," says Laurie Green, a obstetrician-gynecologist
in San Francisco who delivers 400 to 500 babies a year and says she needs to bring in $70
every 15 minutes just to meet her office overhead.
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http://www.wsj.com/articles/SB10001424052702304410504575560081847852618
HEALTH JOURNAL
Updated Oct. 18, 2010 12:01 a.m. ET
By
MELINDA BECK
Some hospitals, like this one in Virginia, post ER wait times on billboards. ASSOCIATED PRESS
12/1/2016 Health Care Tips and Advice: Practicing Patience at the Doctors' Office - WSJ
http://www.wsj.com/articles/SB10001424052702304410504575560081847852618 2/5
Some practices, like Dr. Green's, pride
themselves on running efficiently, and others
are finding ways to streamline office-traffic
flow and cut waiting time. "Patients' time is
valuable. I think practitioners understand
that more and more," says Andre W. Renna,
executive director of a group of 14
gastroenterologists in Lancaster, Pa. He says
even the term "waiting room" has a bad
connotation. Many offices prefer "reception
area" instead.
Some steps to reduce patient wait times are as simple as leaving a few "catch-up" slots
empty each day or stocking the same supplies in the same place in every exam room.
"That way, doctors don't have to stick their heads out the door and ask where things are.
It saves a lot of time," says L. Gordon Moore, a family physician and faculty member of
the Institute for Healthcare Improvement, a Cambridge, Mass.-based non-.
This document provides a performance appraisal for Dr. Zamfirova, an internal medicine physician. It summarizes research on different methods used to evaluate physician performance, including appointment length, clinical performance assessments using composite measures, a physician's capacity for change, and compensation based on RVUs. The research presented acknowledges there are many factors that influence performance evaluations and no single measure can accurately capture a physician's overall quality of care.
Hospital Pathways programme - Intentional RoundingThe King's Fund
Intentional nurse rounding is a structured process where nurses regularly check on patients to address pain, bathroom needs, positioning, and comfort. The evidence shows it can reduce patient call lights by 38%, increase patient satisfaction scores by 12 points, and lower falls by 50% and pressure ulcers by 14%. Key factors for successful implementation include linking the rounds to aims like fall reduction, using measures related to the aims, getting staff and patient input, achieving results before expanding, and celebrating successes.
The emerging healthcare environment requires expanded patient access while delivering optimal outcomes and cost. As healthcare moves form a fee for service model to alternative delivery and payment models, there are opportunities for physical therapy to revolutionize the delivery of musculoskeletal medicine. Physical therapists are uniquely qualified to spearhead musculoskeletal care through direct access with the potential to improve patient satisfaction and outcomes while limiting unneeded medical care. While this model has been described in the military, there are few descriptions of this PT First approach in the private payer arena. This session will provide the attendee with a multifaceted perspective on the impact of physical therapy in emerging, collaborative healthcare models. Approaches to payers and employers with the business implications will be presented that influence these new models. Key strategies to implement a scalable, best practice model will be discussed including the logistical challenges and corollary solutions in the private arena. We will discus our experience implementing novel delivery models for management of neck, back, shoulder and knee pain. The session will deliver practical solutions to the challenges of implementing, assessing, and adapting a theoretical construct to a working viable program. Finally, the session will discuss how the use of a a large Patient Outcomes Registry and analysis of “big data” can drive best practice and inform development of the program.
1) A PDSA was conducted using queuing simulation modeling to analyze patient flow in an orthopedic outpatient clinic (OFC clinic) with the goals of reducing wait times and improving access to radiology services.
2) Data collection and a simplified initial simulation model found patients spent on average 90 minutes in the clinic, with most time spent waiting.
3) More detailed simulation experiments were run varying clinic parameters to identify improvements, with the goal of implementing changes to achieve wait times of 30 minutes or less.
4) Initial modeling results suggested interventions like prioritizing x-rays could reduce waits while maintaining services for senior patients, and engaged physicians to further test and validate proposed scheduling changes through simulation before
Presentation at Pulse Live 18 Oct 2016, in Birmingham. A review of what the General Practice Forward View is doing to reduce workload, and the opportunities for practices themselves to relieve burdens through managing demand differently.
Transitions to new teams are common during healthcare, esp. perioperative care, and are a potent source of error. How do we reduce this source of problems?
This document discusses outcomes research and defines key terms. It provides examples of positive outcome research studies from the Agency for Healthcare Research and Quality (AHRQ) and the Patient-Centered Outcomes Research Institute (PCORI) websites, including studies on chronic pain management, prostate cancer treatment, asthma treatment, and autism interventions. It also notes potential negative outcomes from a treatment decision aid for chest pain and concludes that while the studies are not wasteful, further research is still needed.
This document discusses definitions of outcomes research and nursing outcomes. It provides examples of positive outcome research from the Agency for Healthcare Research and Quality (AHRQ) and the Patient-Centered Outcomes Research Institute (PCORI) websites, including studies on chronic pain management, prostate cancer treatment, asthma treatment, and autism interventions. It also notes some examples that require further research and potential for negative outcomes from a treatment decision aid for chest pain. The conclusion is that while the studies are not wasteful, the results are incomplete and need more research.
This document discusses the future of sleep medicine in the US. It notes that obstructive sleep apnea (OSA) is highly prevalent but largely undiagnosed and untreated, affecting around 30 million people in the US. Current insurance policies require board-certified sleep specialists for reimbursement, but the number of these specialists is declining rapidly. To address the gaps in care, the document proposes increasing training in sleep medicine for pulmonologists, relaxing board certification requirements, simplifying equipment regulations, and enhancing training for general clinicians to manage uncomplicated OSA cases. It also calls for improving training pathways for future sleep scientists and clinicians to ensure the next generation of leaders in the field.
The educational intervention was effective in promoting stretching exercise behavior among office employees. The study involved 87 office employees randomized into an intervention group that received education based on the Health Promotion Model, and a control group. At baseline, the groups were similar in predictors of exercise behavior. After the intervention, the intervention group scored significantly higher than the control group in perceived barriers, self-efficacy, commitment to exercise, and social support for exercise. They also reported significantly greater stretching exercise behavior and less pain severity at the 6-month follow-up compared to the control group. The study demonstrated that an educational program targeting factors from the Health Promotion Model can successfully increase stretching exercises and decrease pain among office employees.
WHITEPAPER HURLEY LAUNCH OF HOMEWARD HEALTHTim Barrett
The document describes a 10-month pilot program conducted at Hurley Medical Center that used Homeward Health's Digital Discharge platform to help reduce potentially avoidable hospital readmissions. The program was administered to 324 patients on an iPad and provided personalized education and a risk score to help prioritize resources. Preliminary results found a promising reduction in readmissions of up to 47% for heart failure patients compared to the previous year's baseline rates.
This document discusses SBARR, a communication tool used to standardize nurse-physician handoffs. It begins by explaining that SBARR stands for Situation, Background, Assessment, Recommendation, and Read-back. It then describes each component of SBARR and provides examples of the information that should be included. The document emphasizes that SBARR improves safety by ensuring all relevant patient information is communicated clearly and concisely between clinicians.
Running Head: PATIENT NO-SHOWS 1
PATIENT NO-SHOWS 7
Patient No-Shows
Student’s name
Institutional affiliation
Part 1- shortage of same-day appointments
Shortage of same-day appointments
A recent study found that the number of same-day appointments increased by more than 20 percent in 2019; it also found that the number of same-day appointments decreased by 2 percent overall. This trend is expected to continue in 2022 and 2023 as the economy improves. The shortage of same-day appointments can cause issues with access to care, especially for people who cannot make regular appointments due to a medical condition or an illness (Hussein, Salim & Ahmed, 2019). The lack of availability also impacts those needing urgent care or treatment before making their regular appointment.
As a result, healthcare faces a shortage of same-day appointments. It is one of the significant issues that is facing the industry today. This is because most people don't have the power to schedule their appointments with the doctor or other health providers on time. They fail to schedule the same-day appointment and then wait several days to get their appointment scheduled again, making them lose out on their treatment. It is estimated that 25% of all patients have to wait for an appointment, which is a considerable amount (Speece, 2019). In addition, the number of patients waiting for same-day appointments will continue to rise because more people are getting sicker and sicker as time goes on. It means that more and more people will need their doctor's visit at the same time as everyone else so they can be seen immediately.
How to increase the utilization of same-day appointments
Some hospitals have implemented programs that allow patients with urgent needs to schedule an appointment on the same day without waiting until their next appointment time for a doctor or nurse practitioner (NP). Some hospitals are utilizing emerging technologies programs to solve the problem. Some programs use online booking tools such as WebMD Doctor Finder or HealthTap, while others allow patients to make an appointment through a phone call, text message, or email. The methods have been cost-effective since the patients do not have to go to the hospitals physically to book their appointment.
The other way a patient can increase the chances of getting a same-day appointment at their preferred facility is by scheduling appointments during off-peak hours and seasons. For instance, there is a period in the United States when most citizens are outside the country as a tourist. The second way is calling in advance and reaching out to your preferred providers. The process is essential since the provider will provide immediate feedback on the request. It will ensure the appointment w.
Tricks of the Trade: Patient Recruitment & Retention for Different Study TypesImperial CRS
In efforts to raise the bar for medical advancement, clinical trials are growing increasingly complex. This complexity, more often than not, leads to costly delays in enrollment. In this ebook, we'll take a look at 4 case studies for different study types, and examine the unique factors to consider during planning.
This document summarizes a pilot program conducted at HonorHealth John C. Lincoln Medical Center aimed at improving patient satisfaction scores through interprofessional rounding. The pilot involved physicians and nurses rounding together and addressing patient concerns documented on response cards. Compliance with addressing concerns first, rounding together, and addressing concerns was recorded over 16 weeks and correlated with changes in HCAHPS scores. Key results found moderate correlation between compliance and improved overall rating scores, and increases between 8-16 percentage points across all measured HCAHPS categories. Continued efforts to streamline physician-nurse meetups before rounding were recommended.
2. In long-term care settings, how does staff working 8 hour shifts,
compared to staff working 12 hour shifts, affect safety and overall
patient care?
3. Have to work 5 days in week to get
full time hours
More faces patients have to learn
Less continuity of care
CON
Shorter work hours
More time in day for other things
Higher patient satisfaction
PRO
4. Long hours
Work fatigue, stress, burnout
More prone to make errors
Due to hand offs and finishing up the
loose ends of work, longer than the 12
hours worked
Decreased levels of alertness
Increased instances of needle-stick
injuries and musculoskeletal injuries
Poorer quality of care and safety
CON
Shorter work week = more time off
Better continuity of care
Less vacancy rates
More satisfaction with schedules
Jobs fill more quickly with 12 hour
shifts
Patients learn who the staff are,
meaning less shift changes
PRO
5. Sentinel Event
Reduce risks of injury or death
Effort to reduce medical errors and worker fatigue
Strategies
6. Hospital Consumer Assessment of Healthcare Providers and Systems
survey (HCAHPS)
Standardized survey instrument and data collection method to
measure the perspectives of the patients in regards to hospital health
care
9 key topics surveyed
7. Nope! Just give me the risks, boys.
What was the HCAHPS Survey outcome?
What does the survey mean?
The contradiction found! The results.
8. Inadequate staffing
Rotating shift schedules
Consecutive shifts
Incentives for being mandated or volunteering
9. Is there a conclusion to this?
What does this all mean?
10. Ball, J., Dall'Ora, C., & Griffiths, P. (2015). The 12-hour Shift: Friend or
Foe? Nursing Times, 111(6), 12-14. Retrieved January 22, 2016, from
http://www.nursingtimes.net/nursing-practice/specialisms/patient-
safety/the-12-hour-shift-friend-or-foe/5081694.article
FMSCA. (2014, April 9). New Hours-of-Service Safety Regulations to
Reduce Truck Driver Fatigue Begin Today . Retrieved from FMSCA:
https://www.fmcsa.dot.gov/newsroom/new-hours-service-safety-
regulations-reduce-truck-driver-fatigue-begin-today
11. Geiger-Brown, J., Rogers, V. E., Trinkoff, A. M., Kane, R. L., Bausell, R. B.,
& Scharf, S. M. (2011, November 28). Sleep, Sleepiness, Fatigue, and
Performance of 12-Hour Shift Nurses. Chronobiology International,
29(2), 211-219. doi:10.3109/07420528.2011.645752
Rollins, J. A. (2015, July/August). The 12-Hour Shift. Pediatric Nursing,
41(4), 162-164. Retrieved January 22, 2016, from
http://eds.b.ebscohost.com.ezproxy.rasmussen.edu/ehost/pdfviewer/p
dfviewer?sid=44ee17a1- 8cf0-43fb-a170-
b34904647a10%40sessionmgr112&vid=8&hid=104
12. Witkoski-Stimpfel, A., Sloane, D. M., & Aiken, L. H. (2012). The Longer
The Shifts For Hospital Nurses, The Higher The Levels Of Burnout And
Patient Dissatisfaction. Health Affairs, 31(11), 2501-2509. doi:
10.1377/hlthaff.2011.1377
Editor's Notes
The debate seems to be ongoing, especially at my work, regarding what is better in the long run, working an 8 hour shift or 12 hour shift. What is safe for the patients and what is safe for the employee? I personally enjoy working 8 hour shifts, however my fellow employees are quite upset that their shifts were changed from the 12 hour shift into the 8 hour without their being asked. Every town hall meeting that is given, employees don’t miss a beat in requesting and even demanding that their 12 hour shift be brought back.
I really want to know, how safe 12 hour shifts versus the 8 hour shift is.
I wanted to start out listing the pros and cons of each shift, so I started out with the 8 hour shift. With the 8 hour shift, working less hours means more time in the day with family and doing life’s business, which translates into nurses and healthcare workers having an improved work/life balance. Nurses who work longer days have issues with burnout, tend to leave for jobs with shorter hours and fatigue is increased on longer shifts, especially when it’s the night shift and normally with older nurses, but I would add younger nurses that are not accustomed to working overnights as well (Rollins, 2015). Yet I read that those who work 12 hour shifts prefer to have these hours because of the increase in time off but then contradict themselves saying that 12 hours are preferred and wanted, yet they are leaving for jobs with shorter hours due to fatigue and burnout and then I hear and read that people are leaving the 8 hour shifts for those that use the 12 hour shifts. What gives? I guess it depends on who you ask and what article you are reading as to the viewpoint.
The 12 Hour shifts have few pro’s while the con’s have the floor with more valid points. The most I could find was redundant when it came to why people wanted to keep the 12 hour shifts, and that goes the same for my place of employment at the VA. It all boils down to working less days in the week which increases the time off. I don’t see it, two 12 hour shifts and two 8 hour shifts, that just gives you one extra day off, I guess if that’s what you are looking for, then that helps. The 12 hour shifts in regards to patient care and satisfaction are worse for quality of care, pretty bad safety records with client care reports and care that is left undone (Rollins, 2015). Increase in hours also has been related to drowsiness while driving, especially if having to work overtime overnight (Geiger-Brown, et al., 2011), this is true among other professions such as truck drivers who were nationally mandated to drive no more than 11 hours daily (FMCSA, 2014). When doing the SBAR with the next shift, or finishing up tasks that have been started but cannot be held over for the next shift or the next day, it is easy for the shift to extend longer than the 12 hours. I see some of the charge nurses work at least an hour over their quitting time trying to finish up. When your ward is full and full of those who need a lot of assistance or constant 1:1 time, that work has to be taken care of first before the paperwork and that paperwork is last to get done when the nurse is needed on the floor for whatever reason. That is the issue at hand, whether its due to inadequate staffing or increased needs on the floor, these are all priorities over paperwork.
The Joint Commission issued a Sentinel Event Alert which indicates a risk or an actual unexpected occurrence of death or serious injury within the healthcare industry. The Joint Commission has urged healthcare organizations to increase efforts to reduce risks for medical errors, such as those related to fatigue, from extended shifts, which includes assessing policies for shift work, development of strategies in an effort to reduce or prevent fatigue, increase teamwork and collaboration in support efforts for those on longer shifts. These would help ensure safe and smooth hand offs at the end of the shift and making sure everyone makes it to their destinations alive(Rollins, 2015).
HCAHPS survey is in regards to study results that compared the nurse’s shift length alongside patient satisfaction. This survey is from the patient’s perspective and goes over 9 key topics such as: communication with the doctors and the nurses, the responsiveness of the staff, pain management, communication in regards to medicine, discharge information, cleanliness of the facility, how quiet the facility is and the facility’s transition of care (Rollins, 2015). Rollins further stated that the outcomes are more severe for those facilities where the staff worked 13 hours or longer and this includes if the patient would recommend the hospital to others. In contrast, those places that use shifts of 8 or 9 hours have better satisfaction amongst their patients.
As I continue to read, and I may have to look more online, I am not finding anything of value in regards to increased hours equals increased errors. It does state that the review of evidence of the impact and effectiveness of 12 hour shifts were inconclusive in the areas of risks to patients, their experience, risks to staff and their experience and how it impacts the hospitals. INCONCLUSIVE! OK, got that off my chest. I shake my head and continue.
So, what about that survey I mentioned earlier? For those hospitals that employ staff that work 12 hour or longer shifts, they have a higher number of patient dissatisfaction and they responded that they would not recommend that hospital to others. They also reported that those nurses sometimes or never communicated well and pain wasn’t very well controlled as well as not getting the help they needed when they wanted. Their conclusion is that patients perceive their care to be worse in the hospitals that employ nurses that work shifts of more than 13 hours. This means that changes are being made. In the fiscal year of 2013, hospitals face reductions in reimbursement if they fail to meet the benchmarks provided by the survey and their conclusions. One of the benchmarks included nurse working conditions that include shift length.
Found the contradiction! Per the survey, most nurses said they were satisfied with their schedule and most of them worked the 12 hour shift. They also found that nurses who worked 12-13 hour shifts were more likely to intend to leave the job than those who worked shorter shifts (Witkoski-Stimpfel, Sloane, & Aiken, 2012). They suggest the reason for this is that nurses seem to underestimate the impact that working the longer shifts because of the appeal of working three days a week instead of five, not to mention this attracts those who want to work second jobs(Witkoski-Stimpfel, Sloane, & Aiken, 2012). Yes, 4 days off, yay! How many hours or days does it require to recuperate from those 3 long days, especially if they are consecutive? I have issues when I work 4 days a row on 8 ½ hours a day at my job. Of course it may just be a mindset, you set your mind to it and away you go, until the last day comes and you are dragging and getting sick. Then you add on overtime and having to work more hours due to mandate or otherwise and ta dah, you are calling in sick for what the military call a MWR (moral, welfare and recreation) day.
12 hour shifts rotate day and night or part of each in each shift. In order to have 12 hour shifts, you have to have a balance between those that enjoy or can tolerate the overnight shift with those who prefer days. If the work week goes from full time of 80 hours, the 12 hour shift would not work because it would be 4 days of work, two 12-hour shifts and two 8-hour shifts or would the full time status go to 72 hours in which three 12-hour shifts and then employ a weekend shift? Would these shifts be consecutive or spaced out? These types of shifts would allow for another job on the side or more home life potentials with flexibility to do whatever.
The issue is the unpredictable nature of healthcare such as employees calling in sick, those who quit, patient needs that change and unpredictable shift lengths when trying to get the day’s work finished which then requires overtime (Witkoski-Stimpfel, Sloane, & Aiken, 2012).
If a co-worker calls in to work stating they aren’t coming in for whatever reason, the calls go out to replace that person. If no one volunteers to come in, then someone is voluntold to come in, which is called mandating. NO ONE likes to be mandated, especially on their weekend off or when something else is going on, which of course there usually is. I have heard a lot of people say that they wont answer their phone if they know its work calling because they know they will be mandated to come in to work. Some places are putting incentives on the mandated shift to entice people to volunteer to come in such as bonuses, another day off, double time, etc.
The only conclusion I can come up with is there is no overwhelming conclusion, no real consensus.
My opinions are that the facts of that particular hospital has to speak for itself in determining which shift should be used by the staff. Perhaps it would be even better determined by going floor by floor or department by department, such as this department has low chance of injury and the patients are pretty self-sufficient, therefore a 12 hour shift can be utilized safely but that department is pretty intense with multiple risk factors that needs due diligence when working, therefore, a shorter shift such as an 8 hour should be utilized instead.
This all means we really are spinning our wheels but going nowhere fast. If people want to work the 12 hour shifts, they will dig in their heels to keep it that way, regardless of the patient care surveys or how their hospital is perceived. That’s the gist of what I read in my references – “At the state level, boards of nursing should consider whether restrictions on nurse shift-length and voluntary overtime are advisable. This idea has been raised in the past, but it has been met with emphatic pushback fro nurses who wish to maintain the status quo” (Witkoski-Stimpfel, Sloane, & Aiken, 2012, para. 6).