9.5 Spotlight Application
Joanne is a new graduate nurse working on a general medical floor in a large urban teaching hospital. She typically cares for between four and six patients during her shift depending on the acuity mix. Many of her patients are direct admit patients or are transferred from the emergency department. Joanne has recently noticed a significant delay on weekend shifts with room turnover and new patient admittance.
Joanne voices her concerns regarding the delays to her unit manager. Her manager agrees that room turnover delays on the weekend have exhibited a significant increase in recent months. She reports that she will investigate the delays further. A few weeks pass and Joanne’s manager reports back that there has been staff reductions in the organization’s environmental services staff on the weekend shifts. As a result, room cleaning has been delayed significantly. Joanne’s manager has voiced her concerns regarding the delays but administration has been reluctant to hire additional staff. Joanne and her manager both feel strongly that investment in staff is needed.
What strategies might Joanne and her manager utilize to reflect the significance of these staff shortages? How might they gather and present information to demonstrate the need for additional environmental services personnel? What stakeholders would be important to engage in this discussion?
When considering the impact of care delays in a health care organization, it is important to gather data to substantiate the significance of delayed care. Joanne and her manager might begin to look at organizational through-put or transfer data to determine how long patients are being held in emergency rooms or other settings during the weekend shifts compared to weekday shifts. Additionally, it would be important for the organization to determine if these delayed admits impeded the ability of the emergency department to accept patients and if the organization was subsequently placed on patient divert due to an inability to care for patients in the emergency room setting. Engaging house supervisors, charge nurses, informatics specialists, etc., may be helpful in determining the significance of the delay and potential quality implications.