An examination of technical efficiency, quality, and patient safety in acute care nursing units.
Using an innovative statistical approach-data envelopment analysis-the authors examined the technical efficiency of 226 medical, surgical, and medical-surgical nursing units in 118 randomly selected acute care hospitals. The authors used the inputs of registered nurse, licensed practical nurse, and unlicensed hours of care; operating expenses; and number of beds on the unit. Outputs included case mix adjusted discharges, patient satisfaction (as a quality measure), and the rates of medication errors and patient falls (as measures of patient safety). This study found that 60% of units were operating at less than full efficiency. Key areas for improvement included slight reductions in labor hours and large reductions in medication errors and falls. The study findings indicate the importance of improving patient safety as a mechanism to simultaneously improve nursing unit efficiency.
Mark
Barbara A
BA
University of North Carolina, Chapel Hill, NC, USA. bmark@email.unc.edu
Jones
Cheryl Bland
CB
Lindley
Lisa
L
Ozcan
Yasar A
YA
D000058:Accidental Falls / Q000706:statistics & numerical data; D000208:Acute Disease / Q000451:nursing; D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000592:standards; D003953:Diagnosis-Related Groups / Q000706:statistics & numerical data; D017598:Efficiency, Organizational; D006757:Hospital Units / Q000458:organization & administration*; D006801:Humans; D016014:Linear Models; D008508:Medication Errors / Q000706:statistics & numerical data; D015401:Nursing Administration Research; D009741:Nursing Staff, Hospital / Q000458:organization & administration* / Q000523:psychology; D017063:Outcome Assessment, Health Care; D010351:Patient Discharge / Q000706:statistics & numerical data; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D013527:Perioperative Nursing / Q000458:organization & administration; D019984:Quality Indicators, Health Care / Q000458:organization & administration*; D017751:Safety Management / Q000458:organization & administration*; D018709:Statistics, Nonparametric; D016526:Workload / Q000706:statistics & numerical data