Seminars for nurse managers最新文献

The nurse managers of the inpatient pediatric units and home care division of Robert Wood Johnson University Hospital met to restructure and optimize the quality of care delivered to children and their families in the home setting. A program was developed using inpatient pediatric staff nurses to perform home visits to children requiring follow-up after an inpatient hospital stay. The nurse managers found home visits could comfortably be delivered by pediatric inpatient nurses if they were appropriately oriented and precepted by experienced home care nurses. When home visits were performed by the nurses who cared for the patient in the hospital, both the child and the family appeared to have an increase in comfort and self-confidence in caring for their child. The program also was successful in reducing the costs associated with pediatric home care. This was achieved by facilitating the downsizing of the inpatient units in periods of low census, as well as in cost avoidance associated with not paying benefits to additional employees that otherwise would have been hired by the home care department. This program could be implemented successfully in institutions that support communication, coordination, and continuous improvement of the programs provided to children and families.

Robert Wood Johnson University Hospital is committed to expanding the continuum of care. To this end, 2 task forces were developed simultaneously. One was created to streamline the discharge transition planning process and produce a more efficient and effective system. The other focused specifically on the coronary artery bypass graft population, with the objective of reducing length of stay without compromising quality of care. This article describes the process from the perspective of the Home Care Department's involvement. Computerization, standardization of physician orders and nursing care plans, and testing patients' knowledge regarding nutrition and medications after discharge from the hospital are described in detail. Including home care in the planning process is the key to achieving a seamless continuum of care.

When planning for growth and management efficiency across urban health systems, economic and market factors present significant service line challenges and opportunities. This article describes the evolutionary integration of emergency services in St John Health System, a large, religious-sponsored health care system located in Detroit, Michigan. Critical business elements, including the System's vision, mission, and economic context, are defined as the framework for site-specific and System-wide planning. The impact of managed care and market changes prompted St John's clinicians and executives to explore how integrating emergency services could create a competitive market advantage.

As new health systems struggle to combine in today's challenging health care market, mechanisms that facilitate and enhance integration become increasingly important. This article describes the use of clinical paths in an integrated delivery system (IDS) as a methodology to establish a single standard of high-quality care. Through education and sharing of staff development resources across the IDS, the system nurse executive at one large IDS promotes professional practice. As clinical paths are developed across the system, the best clinical practice is put to paper, providing a framework for outcome-driven care. The nurse manager assesses staff's use of clinical paths as an evaluation of their skills and competency and to identify new educational and growth opportunities.