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Nurs Adm Q. 1994 Spring;18(3):18-28.

Patient and staff needs drive changes on a postsurgical unit.


In response to a dynamic health care environment and influenced by fiscal pressures, "business as usual" on the postsurgical unit at University of Nebraska Medical Center required examination. Both internal and external factors prompted a staff-driven task force to plan and implement changes. The task force consisted of representatives from staff and management to redesign current practices collaboratively. Issues addressed were nursing workload, responsibilities, scheduling, patient satisfaction, job satisfaction, and professional development. Expected outcomes of changes in the work design on the unit centered on increased efficiency of nursing time, cost effectiveness, and increased satisfaction of patients and nursing staff. The task force proposed and implemented innovative changes in the report and documentation system, utilization of nonprofessional staff, and redesign of work hours. The article presents these changes in the work environment and focuses on a written report system and a clearly defined role for nonprofessional staff.

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