Thank you for your reply:
I can see where unions might get in the way. We don't have a Nurses Union
here.
Implementation was a big problem. Defining roles and getting employee buy
in was a bit of a hassle. However, the duties were assigned on a skills
level basis. The RN's had the most responsibility with administration and
oversight. Then the LVNs, PCS's (Patient Care Specialists: CNA's and
NT's). Respiratory Care stayed in the hands of the RT's. Housekeeping was
assigned to a floor specifically and assisted in handing out trays,
assisted in making beds etc. I believe the average patient load per RN is
8 patients. If and when it gets busy ALL employees are expected to clean,
pass trays and walk patients. This sometimes gets a little intense and
job responsibilities get a little blurred. My wife, a BSN with 27 years,
expects her nurses to make beds , clean rooms, help with tearing down and
building charts, pass trays and take care of patients, all in a days work.
This is also a system that requires management by participation. The
administrative RN for the unit NEEDS to be on the floor doing and helping
as much as possible. Recently the pharmacy started putting satellite
pharmacies on the floors which has really helped in Stat turn a round
times.
Some of this description is in the past tense as though the system is not
in place any more.... well the hospital where my wife works had a major
change in administration and they didn't like the system. However, my
wife kept the system working on her unit, with a lot of long meetings and
serious politics, and administration is now starting to see it her way.
At my hospital the concept has started to take hold after a 2 year pilot.
We are implementing patient care model in the rest of the house in Dec.
and Jan. IF corporate approves. ALL indicators are they will.
Bruce Jones
--"Bruce Jones" <brucej@nwths.com>
Learning-org -- Hosted by Rick Karash <rkarash@karash.com> Public Dialog on Learning Organizations -- <http://www.learning-org.com>