UC Irvine

ABSTRACT

Implementation of an Acuity-adaptable Staffing Model in a Cardiovascular Surgical Unit: A Retrospectivve Review by Kathryn Kay Anotado Lopez Doctor of Nursing Practice, Post- Masters in Nursing Science University of California, Irvine, 2022 Dr. Nicole Martinez, Chair Improvement in the hospital patient experience is at the forefront of health system leadership throughout the country. Acuity-adaptable units allow patients to stay in the same hospital room from the time of admission to the time of discharge, regardless of their change in acuity, thereby improving workflow, patient comfort, and the overall patient experience (Shiva Kumar, Somu & Arun, 2017; Kitchens et al., 2018; Caroll & Frey-Moylan, 2020). Cardiac surgery patients have a specific recovery clinical pathway that allows nurses to identify deviations from the path. Registered nurses (RN) and physician teams trained in cardiac surgery care for the open-heart patient from admission to discharge. This relationship creates continuity of care, active communication, and trusting relationships. The team is knowledgeable and adept with a skillset to provide exceptional care while anticipating any complications (Chindhy et al., 2014; Kitchens et al., 2018; Bonuel, 2017; Costello et al., 2017). The quality of nursing care and anticipation of complications results in best patient outcomes and a high-quality patient experience. A retrospective review was completed on the implementation of an acuity-adaptable cardiovascular surgical unit (CVSU). CVSU outcomes were compared to cardiovascular surgery patients recovered in a traditional staffing model. In the CVSU, having the shared mental model of adaptability and flexibility and a structured orientation with knowledge sharing increased engagement and retention of newly hired staff (Clipper & Cherry, 2015). The cardiovascular surgery acuity-adaptable unit improved both patient outcomes with decreased failure-to-rescue rates (2.9%), decreased lengths of stay in the ICU (3.92 days), and decreased hospital lengths of stay (12.5 days); and improved staff engagement with 4.4 staff engagement mean and minimal turnover (4.9%). With the improvements in patient outcomes and staff engagement in this acuity-adaptable staffing model, the overall patient experience and operational budget can improve for the organization.