33^rd Euro Nursing & Medicare Summit

Biography

Biography: Cathy Rodgers Ward

Abstract

Statement of the Problem: The implementation of healthcare reform requires new innovative nursing care models.  Smaller work teams have been shown to increase teamwork in nursing.  Smaller work teams provide for increased communication and accountability, closer supervision, better support for new staff, and increased knowledge of the patient condition. This study examines the effect of an innovative care team model using smaller, geographic work teams on patient outcomes, continuity of care and teamwork. Methods and Theoretical Orientation: This study was conducted on three hospital units in an academic medical center.  Nurses in these units were divided into equal teams with equal bed counts.  Nurses were assigned to one team and one geographic area only.  Success of the model was assessed after one year including clinical outcomes, patient satisfaction, nurse continuity and nurse teamwork. Results: Nurse continuity improved in all units as evidenced by the average number of new RN encounters (including day and night shifts) decreased from 4.49 per patient to 3.94 per patient. The percent of team intactness was 87.4% indicating the model was successfully followed.  Patient length of stay (LOS) in the hospital decreased across units by 14% therefore reducing overall costs.   Patient satisfaction scores were variable across units.  Satisfaction with nursing teamwork and nursing trust mean scores improved significantly (p=.04) across units. Conclusions and Significance: Developing smaller, more cohesive teams yields benefits of improved continuity of care for patients and improved patient outcomes.  Improved continuity of care for patients may lead to safer care and improved engagement for nurses.  Defining smaller work teams in a distinct geographic area is a model that shows promising results in developing teamwork among nurses and improving patient care.