Productivity gains by specialist nurses

Workload analysis showed that the specialist nursing service in lung cancer in an acute hospital was being used primarily to support processes and administration rather than providing holistic cancer care. An analysis of the inpatient population showed that many people were being admitted for non-acute problems, such as symptom control in advanced disease. As the key workers for patients with lung cancer, the clinical nurse specialists negotiated away the administrative burden and adopted standard, proactive case management in line with national standards. Their proactive and vigilant case management resulted in a drop in admissions for non-acute problems from four to a mean of 0.3 per month. This represents a significant saving in bed days. Clinical nurse specialists who practise proactive case management and re-focus services in line with best practice represent a good return on investment.     

Productivity of respiratory therapy personnel.

An analysis was conducted of 630 periodic observations of work activities of 10 respiratory therapy personnel of a department during 14 consecutive days. It was found that the staff were spending about one-third of their working hours non-productively. The natures of the productive activities related to patient care were identified and each activity was categorized according to the level of difficulty and the skill required for performing it. The peak loads of the department were found to occur immediately before and after patients' meal hours and visiting hours. Nearly one-third of all the staff's productive time was spent administering IPPB. The personnel of various skill levels appeared to be performing different tasks regardless of their levels of difficulty.     

Evaluating Nursing Productivity in Child Health

As nurses are increasingly concerned with assessing and improving their productivity in a variety of settings, they must make systematic use of an evaluation model. The Discrepancy Evaluation Model (DEM) was used to evaluate the productivity of nurses in child health clinics in five centers in the southeastern United States. The first step in any evaluation is to identify standards against which performance can be measured. In this project, no standards were available, and creating them was the first task. Standards for productivity in child health were developed that accounted for differences in clients and the experience level of nurses, while maintaining quality of care. They were situation specific and allowed for the constraints operating in each of the five centers. Discrepancies between the standards and observed performance were identified and underlying factors examined, resulting in a number of recommendations that could streamline the provision of services and improve nursing productivity. The evaluation process can be applied to public health nursing services in a variety of settings.     

Productivity measurement for clinical nurse specialists

The clinical nurse specialists (CNSs) at an 814-bed tertiary care center have collaborated to develop a method for measuring and evaluating productivity of the CNS role. This method, which uses the CIPP Evaluation Model as a framework, parallels the nursing process and is outcome oriented. The applicability of this method to other fixed positions may be of interest to nursing managers and administrators.     

Productivity in education: facing critical options

Even though hospitals across the country are facing tremendous financial pressure, a change in educational focus can offer a positive and exciting outcome. In this climate, educational productivity demands a clear sense of the mission of education as well as the strategic plans of the organization. To survive, educators must be responsive to meeting goals for staff performance and envision themselves as change agents.