Managing unnecessary variability in patient demand to reduce nursing stress and improve patient safety. Export

@article{citeulike:1268864, abstract = {BACKGROUND: Increases in adverse clinical outcomes have been documented when hospital nurse staffing is inadequate. Since most hospitals limit nurse staffing to levels for average rather than peak patient census, substantial census increases create serious potential stresses for both patients and nurses. By reducing unnecessary variability, hospitals can reduce many of these stresses and thereby improve patient safety and quality of care. THE SOURCE AND NATURE OF VARIABILITY IN DEMAND: The variability in the daily patient census is a combination of the natural (uncontrollable) variability contributed by the emergency department and the artificial (potentially controllable) peaks and valleys of patient flow into the hospital fromelective admissions. Once artificial variability in demand is significantly reduced, a substantial portion of the peaks and valleys in census disappears; the remaining censsus variability is largely patient and disease driven. When artificial variability has been minimized, a hospital must have sufficient resources for the remaining patient-driven peaks in demand, over which it has no control, if it is to deliver an optimal level of care. DISCUSSION: Study of operational issues in health care delivery, and acting on what is learned, is critical. Al forms of artificial variation in the demand and supply of health care services should be identified, and pilot programs to test operational changes should be conducted.}, address = {Boston University, Boston, USA. litvak@bu.edu}, author = {Litvak, E. and Buerhaus, P. I. and Davidoff, F. and Long, M. C. and McManus, M. L. and Berwick, D. M.}, citeulike-article-id = {1268864}, citeulike-linkout-0 = {http://view.ncbi.nlm.nih.gov/pubmed/15999963}, citeulike-linkout-1 = {http://www.hubmed.org/display.cgi?uids=15999963}, issn = {1553-7250}, journal = {Jt Comm J Qual Patient Saf}, keywords = {litvak, variability, workflow}, month = {June}, number = {6}, pages = {330--338}, posted-at = {2007-04-30 19:25:51}, priority = {2}, title = {Managing unnecessary variability in patient demand to reduce nursing stress and improve patient safety.}, url = {http://view.ncbi.nlm.nih.gov/pubmed/15999963}, volume = {31}, year = {2005} }

TY - JOUR ID - citeulike:1268864 L3 - citeulike-article-id:1268864 N2 - BACKGROUND: Increases in adverse clinical outcomes have been documented when hospital nurse staffing is inadequate. Since most hospitals limit nurse staffing to levels for average rather than peak patient census, substantial census increases create serious potential stresses for both patients and nurses. By reducing unnecessary variability, hospitals can reduce many of these stresses and thereby improve patient safety and quality of care. THE SOURCE AND NATURE OF VARIABILITY IN DEMAND: The variability in the daily patient census is a combination of the natural (uncontrollable) variability contributed by the emergency department and the artificial (potentially controllable) peaks and valleys of patient flow into the hospital fromelective admissions. Once artificial variability in demand is significantly reduced, a substantial portion of the peaks and valleys in census disappears; the remaining censsus variability is largely patient and disease driven. When artificial variability has been minimized, a hospital must have sufficient resources for the remaining patient-driven peaks in demand, over which it has no control, if it is to deliver an optimal level of care. DISCUSSION: Study of operational issues in health care delivery, and acting on what is learned, is critical. Al forms of artificial variation in the demand and supply of health care services should be identified, and pilot programs to test operational changes should be conducted. IS - 6 JF - Jt Comm J Qual Patient Saf SN - 1553-7250 AD - Boston University, Boston, USA. litvak@bu.edu EP - 338 TI - Managing unnecessary variability in patient demand to reduce nursing stress and improve patient safety. VL - 31 SP - 330 KW - litvak KW - variability KW - workflow AU - Litvak, E AU - Buerhaus, PI AU - Davidoff, F AU - Long, MC AU - McManus, ML AU - Berwick, DM PY - 2005/06// UR - http://view.ncbi.nlm.nih.gov/pubmed/15999963 ER -