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| Increasing Efficiency and Job Satisfaction |
For two decades, nurses have used
Work Complexity Assessment (WCA) to analyze their work and make
decisions about skill mix. The process improves the quality
of patient care, increases efficiency and gives staff nurses
the confidence of to work interdependently with physicians and
other disciplines.
Participants, usually Unit Practice Council members, develop an uncanny appreciation for the professional practice of nursing and the opportunity nursing has in improving outcomes of care. In addition, they gain clarity about the nature of their work, what work is appropriate for delegation, the structural relationships that support delegation, and professional practice concepts.
WCA is not a patient classification or scheduling system, but provides data essential to both.
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| Expert Problem Solving Model |
Staff members who regularly provide patient care, not managers or consultants, are the experts about the complexity and frequency of care activities on the unit. The WCA facilitator leads staff members from an individual nursing unit through a process of discovery. Together, they analyze what is unique about their specific unit.
The process requires careful concentration on the part of the direct caregivers (licensed nurses and others) and their cooperation with the facilitator who leads them through the discovery technique. The expert group members will need to come to consensus when making decisions at each point along the way. As work is analyzed, group members will develop a more extensive awareness of the scope and value of their work and will develop new ways of approaching old problems and dilemmas.
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| A proven process |
Since the 1980s, Creative Health Care Management has used Work Complexity Assessment (WCA) to increase efficiency and job satisfaction in patient care settings. In this transformational process, the staff of an individual nursing unit analyze their unit-specific work. Using the Nursing Interventions Classification (NIC) as the framework for analyzing the complexity and volume of work, the group moves from task-based to knowledge-based decisions. The full team of caregivers (whether they are RNs, LPNs, and unlicensed staff) gains a better understanding of their roles and how to work together.
In 2005, the process was overhauled to shift the emphasis from collecting data to a highly participative educational format that moves nurses from task-based to knowledge-based practice. The revised process helps nurses put the definition of nursing from the ANA Social Policy Statement into action. They help the participants (usually Unit Practice Council members) develop an uncanny appreciation for the professional practice of nursing and the opportunity nursing has in improving outcomes of care.
The process includes information about the scope of professional practice, delegation, and ways to improve expertise in practice. Staff nurses often comment that the WCA helps them know why the work of nursing is so complex.
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| Nursing Interventions Classification |
Using the Nursing
Interventions Classification (NIC) as the framework for
analyzing the complexity and volume of work, the group moves
from task-based to knowledge-based decisions. Participants develop
detailed and easily visualized processes using mind
maps created using MindManager®,
a unique software program developed by CHCM partner Mindjet®.
The staff gains a better understanding of the complexity of
the work, the delegation and care-team building potential for
RNs, LPNs and CNAs and the skill mix needed to meet the unique
needs of the patients on that unit.
The application of NIC terminology is a timely step that introduces
standardized language in a non-threatening, intriguing way while
providing data for improving how work is done. Staff becomes
excited about learning how standardized definitions can help
them in either a paper or electronic world. They see how data
collection about interventions will lead to measuring outcomes
of care in relation to the resources used.
Creative Health Care Management's multi-disciplinary WCA facilitators
are convinced that the revised process improves the quality
of patient care by building confidence of staff nurses to work
interdependently with physicians and other disciplines. These
new facilitators are seasoned healthcare professionals who will
be able to help nurses put the definition of nursing from the
ANA Social Policy Statement into action.
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| Outcomes |
- Creation of a knowledge based, patient-centered approach to care delivery.
- Improved documentation and interdisciplinary communication.
- Sharpened critical thinking skills including new understandings of organizing and accomplishing work activities.
- Establishment of a rational framework for delegation decisions that maximizes skill mix.
- Maximized use of resources through awareness of time spent in value-added and non value-added work.
- Increased appreciation for the complexity of clinical care.
- Development of efficient, effective, interdisciplinary relationships.
- Organization prepared for comprehensive electronic clinical/resource information system.
- Creation of platform to engage the staff in implementing unit-specific responses to organizational initiatives.
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