The evaluation of hospital restructuring efforts: satisfaction, quality, and costs.

This article reports on study evaluating the effects of hospital restructuring on patient satisfaction, nurse satisfaction, cost of care, and clinical quality. The restructuring involved facility redesign, telecommunications enhancement, and implementation of patient care processes incorporating multiskilled personnel and case facilitation systems. The results indicate improved patient and nurse satisfaction, decreased length of stay and variable cost per patient day, and good clinical outcomes.

Measuring critical care redesign: impact on satisfaction and quality.

This report describes restructuring on four critical care units at an acute, tertiary care hospital in South-east Pennsylvania. Utilizing a Patient Centered Care conceptual framework that had been successfully applied in the medical-surgical areas, restructuring involved three main areas: revamping of work processes, inclusive of redesigned staff roles; environmental and facility changes; and enhancement of telecommunication and information systems. Preliminary analyses six months post redesign revealed improvements and maintenance in four outcomes areas--satisfaction, quality and efficiency, and costs of care.

Measuring and evaluating hospital restructuring efforts: 18-month follow-up and extension to critical care, Part 2.

Critical care has enjoyed unobstructed growth during the past two decades; however, to remain viable, process and role changes are pivotal to ensuring continued quality, cost-effective, and efficient care. In this article, the second in a two-part series, the authors describe restructuring efforts, inclusive of their measurement and evaluation strategies, within four critical care units at an acute care, tertiary institution. Special emphasis is placed on the process, the authors' observations, and lessons learned to date.

Measuring and evaluating hospital restructuring efforts. Eighteen-month follow-up and extension to critical care, Part 1.

Increasingly, hospital restructuring is viewed with skepticism because of a lack of systematic and rigorous evaluation of its impact on quality of care. This first article in a two-part series describes comprehensive evaluation of the effects of hospital restructuring on patient satisfaction, nurse satisfaction, costs of care, and clinical quality on four medical-surgical units at a large tertiary hospital. In addition, early application of the model to critical care is described.

A pragmatic approach to measuring and evaluating hospital restructuring efforts.

Organizations have expended enormous resources to restructure care delivery Despite the growing literature describing these organizational innovations there is a paucity of credible data that reflects systematic measurement and evaluation of such changes. This report not only describes a comprehensive research based restructuring effort in a 720 bed acute care hospital, but it also describes an outcomes evaluation strategy and associated findings that may serve as a model and a guide for other healthcare institutions.