A hospital utilization of manpower derived from observation studies



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Efficient utilization of health professionals in hospitals concerns administrators of hospitals, the health professionals, and the society in general. The hospital today is rapidly becoming a social health-centered institution; such an institution suggests that contributions are needed from the health professionals for effecting new health programs. Concern was expressed by Mercy Hospital, Davenport, Iowa, in the direction of utilizing professional knowledge for the transformation of a multidisciplinary melange into an understandable therapeutic plan for the patient. Nurses have reluctantly accepted more and more managerial tasks for unit operations and the responsibility for and the education of unit clerks by on-the-job training. To clarify roles for efficient utilization of manpower in the patient care settings of the hospital, an investigation of on-going activities of head nurse's, nursing team leaders, nursing team members, and unit clerks within patient care settings provided data for differentiating nursing and non-nursing activities. Non-nursing elements were used for construction of formal educational programs for the unit clerks and the unit managers. The learner population included three unit managers and twenty unit clerks who were responsible to hospital administration. Registered nurses from the Department of Education of Mercy Hospital and the directors of the hospital services participated in the instruction of the learners and assisted in the compilation of manuals containing unit clerk information; relationships between patient care units and hospital services; a laboratories manual which listed each test and identified the type and care of specimen required and the name and location of the laboratory to which the specimen was sent; and an x-ray manual which included the purpose of the test, the method of procedure, the designated location for securing necessary drugs, the name of the requisition form used, and where and when such a requisition was to be received. The manuals provided the means to facilitate learning the duties of participants in the program, and subsequently produced a more skillfull understanding of the unit clerk and unit manager's functions, responsibilities, and performance. The results of "A Hospital Utilization of Manpower Program" indicated that: (1) two out of three unit managers successfully completed the program in twelve weeks and eighteen out of twenty unit clerks successfully completed the progam in six weeks; (2) the checklists completed by the nurses indicated that the nurses' performance in non-nursing clerical activities and in supplies and central supply equipment changed significantly and that the nurses' performance in inspection of unit equipment and unit repairs remained unchanged; (3) a frequency count of responses to questions asked in interviews hy the coordinator with the hospital directors provided a unanimous concensus that better communications resulted between the patient care units and the hospital service departments; (4) functions performed by the unit managers related chiefly to supplies and control of supplies and the requisitions for supplies were more efficiently completed when received by the hospital services; (5) the attitudes of the nurses toward the hospital services' personnel showed a marked improvement and that the unit managers and the unit clerks' roles were better understood. The related problem-solving learning experiences of the unit managers, nurses, and the hospital service directors provided evidence of improved communication between patient care units and hospital service departments and the observational data for the nurses and unit clerks' behaviors preprogram and post-program comparisons by analyzing of variances or t-tests for related measures indicated that significant changes were found for the day nurses when less time was spent in indirect patient care activities; non-nursing maintenance activities; non-nursing dietary activities and non-nursing teaching-training activities and when more time was spent in nursing teaching-training activities and off unit activities. The evening nurses' analyses indicated significant changes when less time was spent in non-nursing dietary activities and when more time was spent in off unit activities. The night nurses' analyses indicated significant changes when less time was spent in direct patient care and more time was spent in off unit activities. The day and evening unit clerk's analyses indicated significant changes when less time was spent in non-nursing housekeeping activities and when more time was spent in off unit activities. The program produced the evidence that formal educational programs for the paramedical personnel with the participation of all hospital personnel effected tetter management of services and supplies for patients. The findings promoted the reorganization and utilization of nursing resources. The program revitalized hospital service departments and fostered a cost consciousness among the entire hospital staff. The efficiency of the unit clerks and unit managers in their performance reflected the value of the formal educational programs and the written manuals. As a result of the program there was a growing interest in providing opportunities for personnel growth. Members of the professionals administrative staff made themselves more available to the professional practitioners. Hospital administration was brought into a closer working relationship with the nurse and the physician at the patient care level and better coordination of the multidisciplinary approach to comprehensive patient care was accomplished. Based on the findings of this study it was recommended that the hospital utilization of manpower program be expanded on a gradual basis to all Mercy Hospital patient care departments. Another recommendation concerns the utilization of the nurses' time spent in off-unit activities. Investigations of the ever-increasing number of intensive health care units place question on the aspect of preventive health measures functional within health institutions. This group of registered and licensed health professionals possess latent health talents which could be directed to develop such programs. Specific recommendations from the findings include the transference of the emphasis placed on the value and rewards of good' communication between patient care units and hospital service departments to the value and rewards of good communication between patient and nurse. In recognition of the realities of the present hospital patient care situation the conceptions of the nurse with which most nurses probably enter nursing need reinforcing. The psychological satisfaction of nurses for doing a good job of patient care needs emphasizing. Another recommendation involves a way for rewarding excellence in direct patient care. The recommended applications of the findings include that a hospital utilization of manpower program be applied to any health agency organization—hospital patient care units, hospital service departments, out-patient clinics, public health nursing departments, operating rooms, emergency rooms, geriatric care centers, nursing homes, child care centers, hospitals for crippled children, mental, deaf, or blind institutions, schools for retarded children, school nursing, coronary care centers, intensive care centers, drug-addiction centers, and dialysis centers—where nurses function. The possibility of expanding the program to various business enterprises and service areas which require health programs such as petroleum industries, insurance companies, department stores, and community health agencies is cited. Law enforcement agencies requiring professional medical and health services for the criminally confined could utilize a hospital utilization of manpower program effectively. Suggestions for further study based on the findings of this investigation include a study directed to the nurses' performance versus the seasonal illnesses. Another study is an accurate cost analysis of the program with regard to health values and in providing jobs to the unemployed. An independent; study laboratory multimedia instructional program developed from the instructional units of the program is recommended. The placement of the curricula from a hospital utilization of manpower program for unit managers and unit clerks in Schools of Allied Health and/or Paramedical Departments is also recommended. Great potential seems to lie in determining the motivational factors within the individual which encourage or inhibit maximum contribution to health programs. There is a great deal more studying needed on the impact of interpersonal relationships on personnel within the situations in which they function.



Hospitals--Personnel management., Hospitals--Employees--In-service training.