Worklaod Management leadership and management.ppt

Worklaod Management.ppt

1. Unit XI
Work Load Management
By
Ms. Victoria Samar
Senior. Lecturer
PNS, LUMHS, Jamshoro
Date: March 25
th
, 2015

2. Objectives
At the end of the session the learners will be able to :
•Define Work load management.
•Discuss different patient care processes, input, though
put and output.
•Define efficiency. , productivity and effectiveness.
•Discuss the different types of Nursing Care Models.
•Differentiate the advantages and disadvantages of
each model.
•Discuss application of these models in patient care
areas of the hospital.

3. What does Workload Management
mean?
Definition: Workload management is a process
for determining the proper workload
distributions in order to provide optimal (best
possible) performance for applications and users.
OR
•Workload management is a general term that
refers to staffing and scheduling operations by an
organization’s manager. The three duties of
workload management: staffing, scheduling, and
reallocation.

4. Definition of Productivity
Productivityis the relationship
between the outputsgenerated
from a system and the inputsthat
are used to create those outputs.
Mathematically
P= O/I

5. Systems Concept
outputs
SYSTEM
transformations
inputs
productivity
O
I
Customers
Goods
and
services
Land
people
capital
facilities
equipment
tools
energy
materials
information

6. Efficiency
•Measures the resourcesexpected to be
consumed to the resources actually consumed.
•Hence, it focuses on the inputside of the
system. (To what degree did the system utilize
the “right” things.)

7. Effectiveness
•Measures what the system sets out to
accomplish (objective) with what was actually
accomplished; plan vs. actual
•Hence, effectiveness is an outputmeasure. (Is
the output “right” -right quality, right quantity,
on time, etc.)

8. Nursing Care Delivery
Models

9. Nursing Care Delivery Models
•Detail assignments, responsibility, and
authority to accomplish patient care
•Determine who is going to perform what
tasks, who is responsible, and who makes
decisions
•Match number and type of caregivers to
patient care needs

10. Classic Nursing Care Models
•Total patient care
•Functional nursing
•Team nursing
•Primary nursing
•Modular Nursing
•Patient-Centered Care

11. Total Patient Care
•Nurse is responsible for planning,
organizing, and performing all care
•Oldest method of organizing patient care
•Typically performed by nursing students
•Common use areas—intensive care unit
(ICU) and post anesthetic care unit
(PACU)

12. Total Patient Care cont..
•Advantages
–High degree of autonomy
–Lines of responsibility and accountability are
clear
–Patient receives holistic, unfragmentedcare
•Disadvantages
–Each RN may have a different approach to care
–Not cost-effective
–Lack of RN availability

13. Patient Care
The registered nurse plans,
organizes, and performs all care
Registered
Nurse
8-hour shift
Registered
Nurse
8-hour shift
Registered
Nurse
8-hour shift
Total Patient Care (Case Method) Delivery

14. Functional Nursing
•Staff members assigned to complete specific
tasks for a group of patients
•Evolved during World War II as a result of a
nursing shortage
•Unskilled workers trained to perform routine,
simple tasks
•Common use area—operating room

15. Functional Nursing cont…
•Advantages
–Care is provided economically and efficiently
–Minimum number of RNs required
–Tasks are completed quickly
•Disadvantages
–Care may be fragmented
–Patient may be confused with many care
providers
–Caregivers feel unchallenged

16. Nurse Manager
LPN/LVN
PO Meds
Treatments
RN
Assessments
Care Plans
Nurse Aide
Vital signs
Hygiene
Nurse Aide
Hygiene
Stocking
Assigned Patient Group
Functional Nursing Care Delivery Model

17. Team Nursing
•RN as team leader coordinates care for a
group of patients
•Evolved in the 1950s to improve patient
satisfaction
•Goal was to reduce fragmented care
•Common use areas—most inpatient and
outpatient areas

18. Team Nursing—cont…
•Advantages
–High-quality, comprehensive care with a high
proportion of ancillary staff
–Team members participate in decision making
and contribute their own expertise
•Disadvantages
–Continuity suffers if daily team assignments vary
–Team leader must have good leadership skills
–Insufficient time for planning and
communication

19. Nurse Manager
RN Team Leader
RN
LPNs/LVNs
Nursing Assistants
RN Team Leader
RN
LPNs/LVNs
NursingAssistants
Assigned Patient Group Assigned Patient Group
Team Nursing Model

20. Modular Nursing
•Modification of team nursing
•Patient unit is divided into modules or units
with an RN as team leader
•The same team of caregivers is assigned
consistently to the same geographic area
•Concept evolved to increase RN
involvement in care

21. Modular Nursing (cont)
•Advantages
–Continuity of care is improved
–RN more involved in planning and coordinating
care
–Geographic closeness and efficient communication
•Disadvantages
–Increased costs to stock each module
–Long corridors not conducive to modular nursing

22. Geographic
Patient Unit
Patient Care
Team:
RNs
LPNs/LVNs
Nurse Aides
Meds
Supplies
Linens
Geographic
Patient Unit
Patient Care
Team:
RNs
LPNs/LVNs
Nurse Aides
Meds
Supplies
Linens
Geographic
Patient Unit
Patient Care
Team:
RNs
LPNs/LVNs
Nurse Aides
Meds
Supplies
Linens
Nurse Manager
Modular Nursing Model

23. Primary Nursing
•RN “primary nurse” assumes 24-hour
responsibility for planning, directing, and
evaluating care
•Evolved in the 1970s to improve RN
autonomy
•Common use areas hospice, home health,
and long-term care settings

24. Primary Nursing(cont)
•Advantages
–High-quality, holistic patient care
–Establish rapport with patient
–RN feels challenged and rewarded
•Disadvantages
–Primary nurse must be able to practice with a
high degree of responsibility and autonomy
–RN must accept 24-hour responsibility
–More RNs needed; not cost-effective

25. Primary Nurse
24-hour responsibility for
planning, directing &
evaluating patient care
Patient
Associate Nurses
Provide care
when primary
nurse is off duty
Physician and
other members
of the health care
team
Primary Nursing Model

26. Partnership Model
(Co-Primary Nursing)
•RN is partnered with an licensed practical
nurse/licensed vocational nurse (LPN/LVN) or
nursing assistant to work together consistently
•Modification of primary nursing to make more
efficient use of the RN

27. Partnership Model
(Co-Primary Nursing) cont..
•Advantages
–More cost-effective than primary nursing
–RN can encourage training and growth of
partner
•Disadvantages
–RN may have difficulty delegating to partner
–Consistent partnerships difficult to maintain
due to varied schedules

28. Patient-Centered Care
(Patient-Focused Care)
•Cross-functional teams of professionals and
assistive personnel work together as a unit-
based team
•Recent development in nursing care delivery
models
•More patient oriented than department oriented
•Models vary considerably among facilities

29. Patient-Centered Care
(Patient-Focused Care) cont…
•Advantages
–Patient comes into contact with fewer workers
–Workers are unit based and spend more time in
direct-care activities
–Team is supervised by an RN
–RN is accountable for a wide range of services
and functions at a higher level
–Cost-effective

30. Patient-Centered Care
(Patient-Focused Care) cont…
•Disadvantages
–Major change in organizational structure is
required
–Departments other than nursing must be willing
to accept nursing leadership
–Nurse manager supervises many types of workers

31. Nurse Manager
Patient
Patient CareRespiratory ServicesPatient Transportation
HousekeepingECGAdmission/Discharge Phlebotomy
Physical/Occupational/Speech TherapyDietary Services
Financial Counseling Supply Management
Patient-Centered Care Model

32. Case Management
•First introduced in the 1970s by insurance
companies
•Hospitals adopted the model in the 1980s
•Value demonstrated through research
•Components include:
–Assessment, planning, implementation,
evaluation, and interaction

33. Case Management (cont)
•Variations are found in most health care
organizations
•Reserved for chronically ill patients,
seriously ill patients, or long-term,
expensive cases
•RN assumes a planning and evaluative role;
usually not responsible for direct-care duties
•Supplemental form of care delivery; does
not replace direct-care model

34. RN Case Manager
•Coordinates the patient’s care throughout the
course of an illness from a payer or facility
perspective
–Employee of the payer (external case
management)
–Employee of the health care facility (internal
case management)

35. NURSE CASE MANAGER
Assesses, plans, implements, coordinates,
monitors, and evaluates patient care
options and services to meet health needs
Onset of
Illness
Resolution of
Illness
Collaborates with Nursing,
Physicians, Physical/Speech/
Occupational Therapists, Dietary,
and Ancillary Services
Collaborates With
Patient and Family
Coordinates Services:
Home Care, Hospice,
Extended /Long-term Care
Ambulatory Care Services
Nursing Case Management Model

36. Any Question?

37. Thank you