2.50
Hdl Handle:
http://hdl.handle.net/10755/165812
Category:
Abstract
Type:
Presentation
Title:
Developing a production function for nursing
Author(s):
Garardo, Marie
Author Details:
Marie Gerardo, Virginia Commonwealth University School of Nursing, Richmond, Virginia, USA, (updated February 2015) email: mgerardo@vcu.edu
Abstract:
Nursing units are significant resource consumers within hospitals, yet managers rarely examine efficiency at the nursing unit level. One reason for this information gap may be the lack of an accepted nursing unit production function. Another possibility may be the perception that nursing unit-level data are difficult to find and interpret. The purpose of this study was to utilize Data Envelopment Analysis (DEA) in order to examine which pieces of data a hospital could use to determine a nursing unit production function. Data utilized for this study were obtained as part of the Outcomes Research in Nursing Administration (ORNA) project. The sample consisted of 67 randomly selected non-federal, non-psychiatric, not-for-profit acute care hospitals with more than 200 beds located in 10 southeastern states in the United States. Two randomly selected general medical-surgical nursing units in each hospital participated in the project (n=134). After attrition, the final sample consisted of 62 hospitals and 118 nursing units. Project data were collected via surveys administered in each nursing unit from January 1 -- June 30, 1996. DEA uses a mixture of multiple input and output ratios to determine production efficiency. Output variables used in this study included discharges adjusted by either the HCFA case mix index or by the ORNA study acuity scale completed by nurses on the unit. In addition, patient satisfaction scores, the inverse of medication error and patient fall rates reflected subjective and objective indicators of quality respectively. The input variables used were the number of full-time equivalents by skill mix, the average nursing hours of care per patient day, operating expenses, and wage adjusted direct and indirect nursing care salaries. Eight models using various output and input combinations were created and then evaluated using Mann-Whitney U Tests and Pearson correlation coefficients. In addition, comparisons were made to determine whether or not nursing units remained efficient when output and input combinations changed. For the purposes of this study significance was determined at the p < .05 level. The results of the DEA analysis indicate that the HCFA hospital case mix index accurately reflects nursing perceptions of unit level patient acuity. These findings suggest that either output variable is adequate for use. Furthermore, either the subjective or the objective indicators of quality would be appropriate to use when evaluating nursing unit efficiency. An alternative approach would be to combine all three indicators in order to capture both the perceptual and objective aspects of quality of care. The nature of the data prevented calculation of non-labor operating expenses -- an input variable that is typically used in DEA calculations of hospital-level efficiency. From a practical standpoint, however, number of FTEs in each job classification is likely to be the data source most accessible to nurse managers and administrators. In conclusion, the results of this study demonstrate that data routinely collected by hospital administrators can be used to evaluate overall nursing unit efficiency. These findings suggest a production function that is a combination of quality-related outputs and labor inputs.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Host:
Southern Nursing Research Society
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleDeveloping a production function for nursingen_GB
dc.contributor.authorGarardo, Marieen_US
dc.author.detailsMarie Gerardo, Virginia Commonwealth University School of Nursing, Richmond, Virginia, USA, (updated February 2015) email: mgerardo@vcu.eduen_US
dc.identifier.urihttp://hdl.handle.net/10755/165812-
dc.description.abstractNursing units are significant resource consumers within hospitals, yet managers rarely examine efficiency at the nursing unit level. One reason for this information gap may be the lack of an accepted nursing unit production function. Another possibility may be the perception that nursing unit-level data are difficult to find and interpret. The purpose of this study was to utilize Data Envelopment Analysis (DEA) in order to examine which pieces of data a hospital could use to determine a nursing unit production function. Data utilized for this study were obtained as part of the Outcomes Research in Nursing Administration (ORNA) project. The sample consisted of 67 randomly selected non-federal, non-psychiatric, not-for-profit acute care hospitals with more than 200 beds located in 10 southeastern states in the United States. Two randomly selected general medical-surgical nursing units in each hospital participated in the project (n=134). After attrition, the final sample consisted of 62 hospitals and 118 nursing units. Project data were collected via surveys administered in each nursing unit from January 1 -- June 30, 1996. DEA uses a mixture of multiple input and output ratios to determine production efficiency. Output variables used in this study included discharges adjusted by either the HCFA case mix index or by the ORNA study acuity scale completed by nurses on the unit. In addition, patient satisfaction scores, the inverse of medication error and patient fall rates reflected subjective and objective indicators of quality respectively. The input variables used were the number of full-time equivalents by skill mix, the average nursing hours of care per patient day, operating expenses, and wage adjusted direct and indirect nursing care salaries. Eight models using various output and input combinations were created and then evaluated using Mann-Whitney U Tests and Pearson correlation coefficients. In addition, comparisons were made to determine whether or not nursing units remained efficient when output and input combinations changed. For the purposes of this study significance was determined at the p < .05 level. The results of the DEA analysis indicate that the HCFA hospital case mix index accurately reflects nursing perceptions of unit level patient acuity. These findings suggest that either output variable is adequate for use. Furthermore, either the subjective or the objective indicators of quality would be appropriate to use when evaluating nursing unit efficiency. An alternative approach would be to combine all three indicators in order to capture both the perceptual and objective aspects of quality of care. The nature of the data prevented calculation of non-labor operating expenses -- an input variable that is typically used in DEA calculations of hospital-level efficiency. From a practical standpoint, however, number of FTEs in each job classification is likely to be the data source most accessible to nurse managers and administrators. In conclusion, the results of this study demonstrate that data routinely collected by hospital administrators can be used to evaluate overall nursing unit efficiency. These findings suggest a production function that is a combination of quality-related outputs and labor inputs.en_GB
dc.date.available2011-10-27T14:34:12Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T14:34:12Z-
dc.conference.hostSouthern Nursing Research Societyen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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