The skill mix practice model for nursing: measuring outcome.
OBJECTIVE
This paper reports a study examining the outcome of personnel costs and quality of care after implementing the skill mix practice model for nursing.


BACKGROUND
In response to ever-tightening government budgets and changes in health insurance reimbursement, it may be necessary for hospitals to reassess their practice models to remain competitive and maintain quality of care.


METHODS
Using a pre- and post-test quasi-experimental design with questionnaires, participants were recruited at a teaching hospital in Taiwan. Questions were included on both patient satisfaction with nursing care and nurse satisfaction with nursing aides. The data were collected in 2003.


RESULTS
The cost of implementing the skill mix practice model with 22 nurses and seven nursing aides was 2.7% lower than when only using 25 nurses. In addition, there was a statistically significant difference in patient satisfaction and in nurse satisfaction with the performance of the aides. There was no statistically significant difference in the pre- and post-test outcome measures of both the incidence of falls and the medication error rate.


CONCLUSIONS
To decrease costs and increase quality of care, the skill mix practice model is worthy of consideration for clinical nursing care. This study presents an investigation of the first hospital implementation of the skill mix practice model for nursing in Taiwan, and the results of which can serve as a reference model for hospital nursing practice reform.
Lee
Tso-Ying
TY
Nursing Department, Tri-Service General Hospital, Taipei, Taiwan.
Yeh
Mei-Ling
ML
Chen
Hsing-Hsia
HH
Lien
Gieng-Hueu
GH
D001291:Attitude of Health Personnel; D003362:Cost-Benefit Analysis; D004471:Economics, Nursing; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D016294:Models, Nursing; D017146:Models, Organizational; D009732:Nursing Care / Q000379:methods*; D009741:Nursing Staff, Hospital / Q000458:organization & administration / Q000523:psychology; D017063:Outcome Assessment, Health Care / Q000191:economics / Q000379:methods*; D017060:Patient Satisfaction; D011787:Quality of Health Care