Planning and assessing a cross-training initiative with multi-skilled employees.
BACKGROUND
An improvement initiative begun by nurses at Parkview Episcopal Medical Center (Pueblo, Colo) to develop patient-focused care delivered by multiskilled workers followed a quality improvement methodology. Implementation of the new care delivery system on a model unit--2 South--provided the opportunity to plan, analyze data, and make changes as appropriate. Parkview's indoctrination of the teachings of W. Edwards Deming has helped leaders and staff realize the integral role of training in improvement activities. In his 14 points, Deming emphasizes the importance of employee education and of the employee having a clear understanding of his or her job. The time and money put into up-front education should help ensure the long-term success of this initiative. DEFINING THE CAREPARTNER: Three new multi-skilled positions were developed on 2 South--a Personal CarePartner, a Business CarePartner, and a Clinical CarePartner. By cross-training each of these roles to perform duties formerly done by centralized departments, 2 South was able to cut costs and time while ensuring quality care. TRAINING THE CAREPARTNER: An internally developed training program provided the new CarePartners with up-front education to prepare them to deliver patient-centered care.


RESULTS
2 South has experienced drops in patient falls and medication errors--areas that are often negatively affected when multi-skilled programs are instituted. Patient and physician surveys have shown increased satisfaction with care provided on the unit. The increased efficiency of the model unit has produced these outcomes while cutting costs substantially.


CONCLUSIONS
The interdisciplinary team coordinating the improvement project learned many lessons in the process, including the importance of communication, education, and a sense of humor.
Wermers
M A
MA
Patient Services, Parkview Episcopal Medical Center, Pueblo, Colorado 81003, USA.
Dagnillo
R
R
Glenn
R
R
Macfarlane
R
R
St Clair
V
V
Scott
D
D
D002983:Clinical Competence; D003120:Colorado; D003363:Cost Control; D004496:Education, Continuing / Q000379:methods*; D006745:Hospital Bed Capacity, 300 to 499; D006757:Hospital Units / Q000191:economics / Q000458:organization & administration; D006801:Humans; D007318:Inservice Training; D015402:Nursing Education Research; D018802:Patient-Centered Care / Q000592:standards*; D010561:Personnel Staffing and Scheduling; D010564:Personnel, Hospital / Q000193:education*; D015397:Program Evaluation; D011785:Quality Assurance, Health Care; D000078329:Workforce