Nursing staff mix models and outcomes

Hall, Linda M.

doi:10.1046/j.1365-2648.2003.02786.x

Cited by 53 publications

(43 citation statements)

References 48 publications

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“…These changes in LTC are reflected in our study results, where staff identified challenges with caring for complex residents but having little training and knowledge to do so. An appropriate mix of RNs, RPNs, and unregulated care providers is essential to ensure quality of care, particularly with respect to managing heart failure [39,40].…”

Section: Discussionmentioning

confidence: 99%

Understanding organizational context and heart failure management in long term care homes in Ontario, Canada

Marcella¹,

Nadarajah²,

Kelley³

et al. 2012

Health

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Objective: To assess current heart failure (HF) care processes and organizational context in long-term care (LTC) homes as a prelude to adapting the Canadian Cardiovascular Society (CCS) HF guidelines for use in these settings. Methods: This research reports on the results of thirteen focus groups (N = 83 participants; average of 60 minutes duration) conducted in three Ontario LTC homes to better understand how HF was managed and how organizational context impacted care. Participants included physicians, nurse practitioners, registered nurses, registered practical nurses, and personal support workers. Results: Focus group findings revealed that the complexity of the LTC environment presents challenges for managing HF. Most residents have multiple advanced chronic conditions that must be managed simultaneously. Culturally, LTC is first and foremost a resident's home where residents may choose not to comply with care recommendations. Staff routines, scopes of practice, professional hierarchies, available resources and government regulations limit flexibility in providing care. Staff lacked knowledge, skills and resources for managing HF. Nevertheless, all staff viewed LTC as the preferred place for managing HF, avoiding residents' hospitalizations wherever possible. These data suggest that strategies for improving LTC staff communication and education, strengthening existing relationships between staff, family, residents and community resources, and acquiring additional resources in LTC homes have the potential to improve HF management in this setting. Conclusion: LTC is a complex and dynamic environment that presents many challenges for providing care for residents. This research provides the foundation for subsequent work to develop and test implementation strategies to manage HF in LTC, which are consistent with the CCS HF guidelines and are feasible within LTC staff's work routines, capacities and resources.

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Section: Discussionmentioning

confidence: 99%

Understanding organizational context and heart failure management in long term care homes in Ontario, Canada

Marcella¹,

Nadarajah²,

Kelley³

et al. 2012

Health

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show abstract

“…Non-traditional models may also include skill mix models (McGillis-Hall, 2003). These models are generated from studies that seek to measure staffi ng numbers as an indicator and measure of quality care (Castle & Engberg, 2007;Harrington, 2004;Harrington, 2005aHarrington, , 2005bHarrington, Kovner et al, 2000;Harrington, O'Meara, Collier, Schnelle, 2003;Harrington, Zimmerman, Karon, Robinson, & Beutel, 2000;Mueller & Karon, 2004;Mueller et al, 2006;Räikkönen, Perälä, & Kahanpää, 2007;Schnelle et al, 2004;Zhang et al, 2006).…”

Section: Models Of Care: Definitionmentioning

confidence: 99%

“…This is particularly so in aged care, where the shortage of nursing professionals is heavily felt amongst a client population with multiple, complex, comorbidities and increasing frailty (Australian C N C N C N C N workplace practice model; workforce staffi ng model; staffi ng model; nursing staff mix model; and model of care/care model/nursing care delivery system (Department of Health and Ageing, 2005;Kimball, Joynt, Cherner, & O'Neil, 2007;McGillis-Hall, 2003;McGillis-Hall & Doran, 2003;Wolf & Greenhouse, 2007). The terms 'models of care' and 'staffi ng models' are often used interchangeably and are rarely clearly defi ned within the literature, while 'workplace practice'; 'staffi ng models' and 'models of care' are very closely related and enmeshed with each other.…”

mentioning

confidence: 99%

Beyond ‘doing’: Supporting clinical leadership and nursing practice in aged care through innovative models of care

Venturato

Drew²

2010

Contemporary Nurse

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Contemporary health care environments are increasingly challenged by issues associated with the recruitment and retention of qualified nursing staff. This challenge is particularly felt by residential aged care providers, with registered nurse (RN) numbers already limited and resident acuity rapidly rising. As a result, aged care service providers are increasingly exploring creative and alternative models of care. This article details exploratory research into a pre-existing, alternative model of care in a medium sized, regional residential aged care facility. Research findings suggest that the model of care is complex and multi-faceted and is an example of an integrated model of care. As a result of the implementation of this model of care a number of shifts have occurred in the practice experiences and clinical culture within this facility. Results suggest that the main benefits of this model are: (1) increased opportunities for RNs to engage in clinical leadership and proactive care management; (2) improved management and communication in relation to work processes and practices; and (3) enhanced recruitment and retention of both RNs and care workers.

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“…In designing the survey instrument, the relevant writing in the service recovery performance literature (Mowday et al, 1979;Lucas et al, 1990;Parasuraman et al, 1990;Lytle et al, 1998;Yavas, 1998;Boshoff and Allen, 2000;Yoon et al, 2001;Babakus et al, 2003;Yavas et al, 2003) and the healthcare literature (Lytle et al, 1998;Rafferty et al, 2001;Budge et al, 2003;McGillis, 2003) were canvassed. Multiple item indicators were employed from this literature and adapted to operationalise the study constructs in the context of a healthcare setting.…”

Section: Measurementmentioning

confidence: 99%

The effect of management commitment to service quality on frontline employees' affective and performance outcomes: an empirical investigation of the New Zealand public healthcare sector

Ashill

Carruthers

Krisjanous

2006

J of Philanthropy and Mktg

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*Very little attention has been given to understand the antecedents of service recovery performance in a public healthcare setting. In this study, a cross-sectional survey investigates a model of service recovery performance. Frontline hospital employees completed a self-administered questionnaire on how factors characterising management commitment to service quality (MCSQ) affect their service recovery efforts. The results suggest the influence of MCSQ is mediated by frontline employees' affective commitment to their hospital. The research advances understanding of frontline service recovery performance in a public healthcare setting and the findings indicate that public healthcare managers can take actions on a number of fronts to assist progress towards the achievement of frontline service recovery excellence.

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Nursing staff mix models and outcomes

Abstract: Staff mix model was related to Registered Nurses' perceptions of the quality of patient care. It was also evident that other variables within the work environment might have more influence on the outcomes examined than the independent variable of staff mix.

Cited by 53 publications

References 48 publications

Understanding organizational context and heart failure management in long term care homes in Ontario, Canada

Understanding organizational context and heart failure management in long term care homes in Ontario, Canada

Beyond ‘doing’: Supporting clinical leadership and nursing practice in aged care through innovative models of care

The effect of management commitment to service quality on frontline employees' affective and performance outcomes: an empirical investigation of the New Zealand public healthcare sector

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