Redesigning the nursing care delivery system at Fairfax Hospital

Area of Science:

• Healthcare Management
• Nursing Practice
• Patient Care Improvement

Background:

• Nursing delivery processes require optimization to meet evolving patient and clinician needs.
• A dual approach, involving leadership initiatives and unit-level redesign, is being implemented.
• Reevaluating skill mix and adopting patient-centered approaches are key focus areas.

Purpose of the Study:

• To describe the comprehensive redesign of nursing delivery processes at Fairfax Hospital.
• To identify and address improvement opportunities across inpatient nursing units.
• To implement a family-centered care model based on stakeholder feedback.

Main Methods:

• A top-down and bottom-up strategy was employed for process redesign.
• Nursing leaders identified system-wide improvements, such as skill mix reevaluation.
• Inpatient units, like the postpartum unit, redesigned processes based on customer (patient) requirements, shifting to a 'wellness' approach.

Main Results:

• Customer research indicated a strong desire for family-centered care from competent, caring clinicians.
• Flow charting identified common improvement opportunities, including reduced shift-reporting time.
• Nurses are empowered to make local decisions, contributing to a more responsive care environment.

Conclusions:

• The redesign fosters a more patient-centered and efficient nursing delivery system.
• Empowering nurses with local decision-making authority enhances care quality.
• Ongoing efforts are tracking quantitative results to further validate improvements in nursing care.