title: Implementing an acuity-adaptable care model in a rural hospital setting.
abstract: OBJECTIVE
  This study examined the effects of an acuity-adaptable care model in a rural hospital setting on nurse satisfaction, patient satisfaction, patient safety, and quality indicators (events, falls, and medication errors), patient length of stay (LOS), and worked hours per patient-day (WHPPD).
  
  
  BACKGROUND
  Acuity-adaptable care models have been implemented as a nursing strategy to improve workflow through the elimination of unit-to-unit patient handoffs. However, to our knowledge, this model of care has not been studied in a rural hospital setting.
  
  
  METHODS
  A descriptive, comparative design with repeated measures was utilized for this study. A professional nurse survey was created to measure staff satisfaction; separate t tests for percentages were utilized to evaluate patient satisfaction and patient safety/quality indicators. Financial data were examined to perform the analysis of patient LOS and WHPPD.
  
  
  RESULTS
  The nurse satisfaction survey demonstrated a decrease in weekly floating and cancellations due to low census. There was a statistically significant improvement in patient satisfaction for overall rating and willingness to recommend the hospital. No significant difference was noted in patient quality indicators or LOS; however, there was a favorable trend for all events and medication errors. This study also found a decrease in WHPPD, with a corresponding salary expense reduction reported.
  
  
  CONCLUSIONS
  Acuity-adaptable units may be a viable strategy for rural facilities.
authors: St Luke's University Health Network, Quakertown, Pennsylvania 18951, USA. Kathy.Ramson@sluhn.org
authors: Kathy Paulik
authors: KP
authors: Ramson
authors: Linda
authors: L
authors: Dudjak
authors: Michele
authors: M
authors: August-Brady
authors: Jill
authors: J
authors: Stoltzfus
authors: Paula
authors: P
authors: Thomas
mesh_terms: D000208:Acute Disease; D001291:Attitude of Health Personnel; D003695:Delivery of Health Care / Q000458:organization & administration* / Q000592:standards; D019538:Health Care Surveys; D006780:Hospitals, Rural / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D007902:Length of Stay; D017146:Models, Organizational; D009718:Nurse Administrators / Q000458:organization & administration*; D009741:Nursing Staff, Hospital / Q000458:organization & administration* / Q000523:psychology; D061214:Patient Safety; D017060:Patient Satisfaction; D010414:Pennsylvania; D011787:Quality of Health Care; D013598:Systems Theory