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Nursing Services Delivery Theory: an open system approach.

Raquel M Meyer¹, Linda L O'Brien-Pallas

¹Nursing Early Career Researcher Ontario Ministry of Health & Long-Term Care, Lawrence Bloomberg Faculty of Nursing, University of Toronto, Ontario, Canada. raquel.meyer@utoronto.ca

Journal of Advanced Nursing

|September 14, 2010

Summary

This study introduces the Nursing Services Delivery Theory, applying open system theory to healthcare organizations. It provides a framework for understanding nursing work, staffing, and environments to improve management decisions.

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Area of Science:

Healthcare Management
Nursing Theory
Organizational Theory

Background:

Nursing work mechanisms and staffing impacts are poorly understood, creating a 'black box' in healthcare management.
A theoretical framework is needed to link nursing work, staffing, work environments, and patient outcomes.
Current management decisions on nurse staffing lack robust theoretical underpinnings.

Purpose of the Study:

To derive the Nursing Services Delivery Theory by applying open system theory to large-scale healthcare organizations.
To provide a theoretical structure for understanding the dynamics of nursing services delivery.
To inform management decisions regarding nurse staffing and resource allocation.

Main Methods:

Literature search of CINAHL and Business Source Premier (1980-2008).
Keywords included: theory, models, organization, management, nursing units.
Inclusion of seminal works in organizational and nursing management.

Main Results:

Conceptualized healthcare organizations as open systems with characteristics like energy transformation and dynamic steady state.
The Nursing Services Delivery Theory posits dynamic interactions between input, throughput, and output factors.
This theory addresses work demands on nursing groups at the point of care.

Conclusions:

The Nursing Services Delivery Theory offers a structure to reconcile research on nursing work, staffing, and environments.
It is applicable across diverse settings, cultures, and countries.
The theory can guide future research and management of nursing services in large healthcare organizations.