title: Measuring and evaluating hospital restructuring efforts. Eighteen-month follow-up and extension to critical care, Part 1.
abstract: Increasingly, hospital restructuring is viewed with skepticism because of a lack of systematic and rigorous evaluation of its impact on quality of care. This first article in a two-part series describes comprehensive evaluation of the effects of hospital restructuring on patient satisfaction, nurse satisfaction, costs of care, and clinical quality on four medical-surgical units at a large tertiary hospital. In addition, early application of the model to critical care is described. A quasiexperimental pre- and post-design combined with concurrent control units for selected measures was the overall strategy. The authors conclude that comprehensive restructuring of hospital-based care can take place in a manner that preserves multiple dimensions of quality while decreasing costs. This only can be ascertained, however, through rigorous and systematic measurement and evaluation. Part 2 will detail application and evaluation of the restructuring model in the critical care environment.
authors.affiliation: Lehigh Valley Hospital, Allentown, PA, USA.
authors.forename: Y E
authors.initials: YE
authors.lastname: Bryan
authors.forename: K S
authors.initials: KS
authors.lastname: Hitchings
authors.forename: M A
authors.initials: MA
authors.lastname: Fuss
authors.forename: M A
authors.initials: MA
authors.lastname: Fox
authors.forename: M T
authors.initials: MT
authors.lastname: Kinneman
authors.forename: M J
authors.initials: MJ
authors.lastname: Young
mesh_terms: D003422:Critical Care / Q000592:standards; D005069:Evaluation Studies as Topic; D017052:Hospital Mortality; D006754:Hospital Restructuring / Q000592:standards*; D006757:Hospital Units / Q000458:organization & administration*; D006801:Humans; D007588:Job Satisfaction; D007902:Length of Stay; D009741:Nursing Staff, Hospital / Q000523:psychology; D017060:Patient Satisfaction; D010414:Pennsylvania; D011785:Quality Assurance, Health Care; D011787:Quality of Health Care