Topic: Workload

Management

Subject : Leadership and Management

Group F Members
Sana Shoukat
Shah Faisal
Ahmed Ali
Ali Mujtaba
Kaushaliya Devi
Shohaib Ahmed
Sajjid Ali
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 Unit XI
Work Load Management

By
Ms. Victoria Samar
Senior. Lecturer
PNS, LUMHS, Jamshoro
Date: March 25th, 2015

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 Objectives
At the end of the presntation the students will be able
to :
• Define Work load management.
• Discuss different patient care processes, input, though
put and output.
• Define efficiency. , productivity and effectiveness.
• Discuss the different types of Nursing Care Models.
• Differentiate the advantages and disadvantages of
each model.
• Discuss application of these models in patient care
areas of the hospital.

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 Workload Management
• Workload
• The amount of work assigned to or expected from a
worker in a specified time period.
• Workload Management
• Workload management is a process for determining
the proper workload distributions in order to provide
optimal (best possible) performance for applications
and users. The three duties of workload
management : staffing, scheduling and reallocation.

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 Input -Throughput- Output
Conceptual Model

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 Productivity
• Productivity is the relationship between the output
generated from a system and the inputs that are
used to create those outputs.
• Productivity is generally regarded as a measure of
outputs divided by inputs.
• Mathematically

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 Efficiency
• Efficiency means doing things right.
• Measures the resources expected to be consumed to
the resources actually consumed and focuses on
getting maximum output with minimum efforts and
resources.
• Hence, it focuses on the input side of the system (to
what degree did the system utilize the "right" things).

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 Effectiveness
• Effectiveness is a measure of doing the "right
things" in the right way at the right time.
• Measures what the system sets out to
accomplish (objective) with what was actually
accomplished; plan vs actual.
• Hence, effectiveness is an output measure.

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 Effectiveness Efficiency

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 Nursing Care Delivery
Models

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 Nursing Care Delivery Models

• Detail assignments, responsibility, and

authority to accomplish patient care
• Determine who is going to perform what
tasks, who is responsible, and who makes
decisions
• Match number and type of caregivers to
patient care needs

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 Classic Nursing Care Models
• Total patient care
• Functional nursing
• Team nursing
• Primary nursing
• Modular Nursing
• Patient-Centered Care
• Case Management Model

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 Total Patient Care
• Nurse is responsible for planning, organizing,
and performing all care including personal
hygiene, medications, emotional support,
education as required by patient.
• Oldest method of organizing patient care
• Common use areas—intensive care unit (ICU)
and post anesthetic care unit (PACU)

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 Total Patient Care Model

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 Registered Registered Registered
Nurse Nurse Nurse
8-hour shift 8-hour shift 8-hour shift

Patient Care
The registered nurse plans,
organizes, and performs all care

Total Patient Care (Case Method) Delivery

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 Total Patient Care
(Cont....)
• Advantages
• High degree of autonomy
• Lines of responsibility and accountability are clear
• Patient receives holistic, unfragmented care
• Disadvantages
• Each RN may have a different approach to care
• Not cost effective
• Lack of RN availability

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 Functional Nursing
Model
• The functional nursing model is task-oriented
and assigns specific tasks to each nursing
based on their expertise.
• For example, one nurse may be responsible
for administering medications while another
nurse may be responsible for performing
assessments.

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 Nurse Manager

LPN/LVN RN Nurse Aide Nurse Aide

PO Meds Assessments Vital signs Hygiene
Treatments Care Plans Hygiene Stocking

Assigned Patient Group

Functional Nursing Care Delivery Model

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 Functional Nursing
Model (Cont....)
• Advantages
• Minimum number of RNs required
• Tasks are completed quickly
• Care is provided economically and efficiently
• Disadvantages
• Care may be fragmented
• Patient may be confused with many care providers
• Caregivers feel unchallenged

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 Team Nursing
• A team of nurses work together to provide
care to a group of patients.
• Each nurse is responsible for specific tasks
but they work together to coordinate care
and communication with each other.
• Evolved in the 1950s to improve patient
satisfaction
• Goal was to reduce fragmented care.

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 Nurse Manager

RN Team Leader RN Team Leader

RN RN
LPNs/LVNs LPNs/LVNs
Nursing Nursing
Assistants Assistants

Assigned Patient Group Assigned Patient Group

Team Nursing Model

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 Team Nursing—cont …
• Advantages
– High-quality, comprehensive care with a high
proportion of ancillary staff
– It promotes collaboration and communication
between nurses
– Team members participate in decision making
and contribute their own expertise
• Disadvantages
– It can be challenging to manage.
– Team leader must have good leadership skills
– Insufficient time for planning and
communication
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 Modular Nursing
• Modification of team nursing
• Patient unit is divided into modules or units
with an RN as team leader
• The same team of caregivers is assigned
consistently to the same geographic area
• Concept evolved to increase RN
involvement in care

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 Nurse Manager

Geographic Geographic Geographic

Patient Unit Patient Unit Patient Unit
Patient Care Patient Care Patient Care
Team: Team: Team:
RNs RNs RNs
LPNs/LVNs LPNs/LVNs LPNs/LVNs
Nurse Aides Nurse Aides Nurse Aides
Meds Meds Meds
Supplies Supplies Supplies
Linens Linens Linens

Modular Nursing Model

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 Modular Nursing (cont)
• Advantages
– Continuity of care is improved
– RN more involved in planning and coordinating
care
– Geographic closeness and efficient communication
• Disadvantages
– Increased costs to stock each module
– Long corridors not conducive to modular nursing

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 Primary Nursing
• The primary nursing model is a patient-
centered approach in wich one nuse or
primary care provider manages the oveall
health and wellbeing of the patients.
• Evolved in the 1970s to improve RN
autonomy
• Common use areas hospice, home health,
and long-term care settings

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 Primary Nurse
24-hour responsibility for
Associate
Physician and planning, directing & Nurses provide
other evaluating patient care care when
members of
primary nurse is
the health
off duty
care team

Patient

Primary Nursing Model

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 Primary Nursing(cont)
• Advantages
– High-quality, holistic patient care
– Establish rapport with patient
– RN feels challenged and rewarded
• Disadvantages
– Primary nurse must be able to practice with a
high degree of responsibility and autonomy
– RN must accept 24-hour responsibility
– More RNs needed; not cost-effective

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 Partnership Model
(Co-Primary Nursing)
• RN is partnered with an licensed practical
nurse/licensed vocational nurse (LPN/LVN) or
nursing assistant to work together consistently
• Modification of primary nursing to make
more efficient use of the RN

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 Partnership Model
(Co-Primary Nursing)
• cont..
Advantages
– More cost-effective than primary nursing
– RN can encourage training and growth of
partner
• Disadvantages
– RN may have difficulty delegating to partner
– Consistent partnerships difficult to maintain
due to varied schedules

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 Patient-Centered Care
(Patient-Focused
Care)
• Cross-functional teams of professionals and
assistive personnel work together as a unit-
based team
• Recent development in nursing care delivery
models
• More patient oriented than department
oriented
• The care team includes all disciplines.
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 Nurse Manager
Patient Care Respiratory Services Patient Transportation
Housekeeping ECG Admission/Discharge Phlebotomy
Physical/Occupational/Speech Therapy Dietary Services
Financial Counseling Supply Management

Patient

Patient-Centered Care Model

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 Patient-Centered Care
(Patient Focused Care)
cont....
• Advantages
– Patient comes into contact with fewer workers
– Workers are unit based and spend more time in
direct-care activities
– Team is supervised by an RN
– RN is accountable for a wide range of services
and functions at a higher level
– Cost-effective

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 Patient-Centered Care
(Patient Focused Care) cont....
• Disadvantages
– Major change in organizational structure is
required
– Departments other than nursing must be willing
to accept nursing leadership
– Nurse manager supervises many types of workers

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 Case Management
• First introduced in the 1970s by insurance
companies
• Hospitals adopted the model in the 1980s
• Case management is a model of care
delivery in which an RN case manager
coordinates the patient's care through out the
course of an illness.

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 Case Management (cont)
• Components include :
• Assessment, planning, implementation,
evaluation and interaction.
• Reserved for chronically ill patients,
seriously ill patients, or long-term,
expensive cases.
• Supplemental form of care delivery; does
not replace direct-care model

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 RN Case Manager
• Coordinates the patient’s care throughout the
course of an illness from a payer or facility
perspective
– Employee of the payer (external case
management)
– Employee of the health care facility
(internal case management)

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 Collaborates with
patient and family

NURSE CASE MANAGER

Onset of Assesses, plans, implementation, Resolution o
Illness coordination, monitors and evaluates of Illness
patient care options and services to
meet health needs

Collaborates with Nursing, Coordinates Services:

Physicians, Physical/Speech/ Home Care, Hospice,
Occupational Therapists, Extended /Long-term Care
Dietary,Ancillary Services Ambulatory Care Services

Nursing Case Management Model

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 Thank you

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