2.50
Hdl Handle:
http://hdl.handle.net/10755/157368
Type:
Presentation
Title:
DOES THE IMPLEMENTATION OF HOSPITAL IT SYSTEMS REQUIRE MORE NURSE STAFFING?
Abstract:
DOES THE IMPLEMENTATION OF HOSPITAL IT SYSTEMS REQUIRE MORE NURSE STAFFING?
Conference Sponsor:Western Institute of Nursing
Conference Year:2010
Author:Spetz, Joanne, Ph.D.
P.I. Institution Name:University of California San Francisco
Title:Professor
Contact Address:3333 California Street, Suite 410, San Francisco, CA, 94118, USA
Co-Authors:Ciaran Phibbs; James Burgess
PURPOSES/AIMS:
This study examines the effects of two major IT systems on nursing hours in Department of Veterans Affairs (VA) hospitals.
BACKGROUND:
Health information systems are promoted as a key means to improve patient safety and the quality of care. These benefits may come at substantial cost, including labor costs associated with transitioning to the new system and its ongoing use.
METHODS:
Using VA Payroll data, we measured nurse staffing and the characteristics of nursing staff for 120 VA Medical Centers over 44 quarters. These data were merged with a unique dataset on the timing of IT implementation and with data on facility characteristics such as teaching status, patient volume, and acuity. Site visits were conducted at seven VA facilities to obtain qualitative data to augment the quantitative findings.
RESULTS:
RN hours dropped among VA hospitals from 1996 to 2002, rose slightly to 2004, and then dropped from 2004 to 2006. There was an increase in overtime from 1999 to 2000, when the IT systems were being implemented in most hospitals, and a continued gradual increase through 2003. Multivariate regression equations find that after controlling for hospital and staff characteristics, the electronic medical record system and bar-code medication administration in acute care units did not have any statistically significant association with changes in RN staffing. The implementation of bar coding in intensive care units was associated with an increase in RN hours per patient day, but not total RN hours or the share of overtime. Interviewees reported that they increased nurse staffing to ensure adequate patient care, even though they had not been allocated fund to do so. Some managers and nurses said they still think nurse staffing is inadequate given the demands on their time.
CONCLUSIONS:
There was little change in nurse staffing as the result of IT implementation in the VA. Previous research of the VA systems found minimal improvements in some quality indicators such as those developed by AHRQ. This may be because of the VA did not intentionally increase staffing during the implementation of IT systems.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleDOES THE IMPLEMENTATION OF HOSPITAL IT SYSTEMS REQUIRE MORE NURSE STAFFING?en_GB
dc.identifier.urihttp://hdl.handle.net/10755/157368-
dc.description.abstract<table><tr><td colspan="2" class="item-title">DOES THE IMPLEMENTATION OF HOSPITAL IT SYSTEMS REQUIRE MORE NURSE STAFFING?</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2010</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Spetz, Joanne, Ph.D.</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of California San Francisco</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Professor</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">3333 California Street, Suite 410, San Francisco, CA, 94118, USA</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">jojo@thecenter.ucsf.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Ciaran Phibbs; James Burgess</td></tr><tr><td colspan="2" class="item-abstract">PURPOSES/AIMS:<br/>This study examines the effects of two major IT systems on nursing hours in Department of Veterans Affairs (VA) hospitals.<br/> BACKGROUND:<br/>Health information systems are promoted as a key means to improve patient safety and the quality of care. These benefits may come at substantial cost, including labor costs associated with transitioning to the new system and its ongoing use. <br/> METHODS:<br/>Using VA Payroll data, we measured nurse staffing and the characteristics of nursing staff for 120 VA Medical Centers over 44 quarters. These data were merged with a unique dataset on the timing of IT implementation and with data on facility characteristics such as teaching status, patient volume, and acuity. Site visits were conducted at seven VA facilities to obtain qualitative data to augment the quantitative findings.<br/> RESULTS:<br/>RN hours dropped among VA hospitals from 1996 to 2002, rose slightly to 2004, and then dropped from 2004 to 2006. There was an increase in overtime from 1999 to 2000, when the IT systems were being implemented in most hospitals, and a continued gradual increase through 2003. Multivariate regression equations find that after controlling for hospital and staff characteristics, the electronic medical record system and bar-code medication administration in acute care units did not have any statistically significant association with changes in RN staffing. The implementation of bar coding in intensive care units was associated with an increase in RN hours per patient day, but not total RN hours or the share of overtime. Interviewees reported that they increased nurse staffing to ensure adequate patient care, even though they had not been allocated fund to do so. Some managers and nurses said they still think nurse staffing is inadequate given the demands on their time.<br/> CONCLUSIONS:<br/>There was little change in nurse staffing as the result of IT implementation in the VA. Previous research of the VA systems found minimal improvements in some quality indicators such as those developed by AHRQ. This may be because of the VA did not intentionally increase staffing during the implementation of IT systems. <br/></td></tr></table>en_GB
dc.date.available2011-10-26T19:48:33Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T19:48:33Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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