Evaluation of the multifunctional worker role: a stakeholder analysis.

Health care organizations are rethinking how care is delivered because of incentives generated by managed care and a competitive marketplace. An evaluation of a work redesign project that involved the creation of redesigned unlicensed caregiver roles is described. The effect of model implementation on patients, multiple categories of caregivers, and physicians was measured using several different approaches to data collection.

Improving staffing with a resource management plan.

To change from a crisis to a proactive mode for staffing, scheduling, resource pool utilization, information management, and unit workload, nursing leaders developed a resource management plan. Changes that assisted in achieving that goal included: revision of department scheduling guidelines, elimination of day shift central supervisor, responsibility for daily staffing moved to unit-based managers, creation of a staffing model for the nursing resource pool staff, establishment of ideal complement of positions for every unit, expectation for unit to meet its staffing model every shift, reinforced department efforts to fill vacant positions, participation in computerized databases to study the use of resources, and identified critical staffing indicators for each unit.

Changing with the times: reconfiguring a mental health facility in response to changing market conditions.

A 130-bed private mental health hospital in Ann Arbor, Michigan, was a state-of-the-art, progressive facility when it was built in 1986. Since then, changing reimbursement patterns and the shift from inpatient to outpatient services have led to an organizational and physical reconfiguration of the facility to accommodate both mental health and chemical dependency programs. This paper describes the original design of the building and how it was modified in 1990 to achieve organizational objectives and enhance patient care.