技能组合与灵活性:解码护士人员对关键入口医院的影响
Dinesh R Pai1, Esmaeil Bahalkeh2
1School of Business Administration, Penn State Harrisburg, Middletown, Pennsylvania, USA.
概括
更高的注册护士 (RN) 技能组合通过降低成本和停留时间,提高了临床医院 (CAH) 的效率. 工作人员的灵活性减少了再接收,但增加了停留时间,突显了农村医疗保健的复杂平衡.
科学领域:
- 医疗服务研究
- 护理管理
- 农村卫生政策
背景情况:
- 临床医院对于农村医疗保健至关重要.
- 护士人员配置模式对医院的运作和患者的结果有很大影响.
- 了解护士技能组合和灵活性对CAH可持续性的影响至关重要.
研究的目的:
- 分析护士人员 (技能组合和灵活性) 对宾夕法尼亚州CAH的财务可持续性,效率和护理质量的影响.
- 提供数据驱动的洞察力, 以优化农村医院的护士人才战略.
主要方法:
- 使用357名宾夕法尼亚州CAH (2000-2023) 不平衡小组数据的回顾性纵向研究.
- 使用双向固定效应回归模型对医院绩效指标进行评估.
- 控制医院特定的社会经济和人口因素.
主要成果:
- 更高的注册护士 (RN) 技能组合显著降低了调整后退院费用 (CPAD) 和平均停留时间 (ALOS).
- 提高护士灵活性显著降低了再入院指数,但增加了ALOS.
- 在技能组合和总利率,每日调整的患者成本 (CPPD) 或再入院指数之间没有发现显著的关联,也没有在灵活性和财务指标之间发现.
结论:
- 更丰富的RN技能组合通过降低成本和停留时间来提高效率.
- 增加人员灵活性通过减少再录取来提高质量,但可能会延长ALOS.
- 为了优化资源使用和改善CAH患者的治疗结果,必须对RN技能组合和灵活性进行战略管理.
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