ArticleBMJ quality & safety2021
Evaluation of the impact of an augmented model of The Productive Ward: Releasing Time to Care on staff and patient outcomes: a naturalistic stepped-wedge trial.
Article in BMJ quality & safety, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.
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Who cites it
5 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- The development of the concept of return-on-investment from large-scale quality improvement programmes in healthcare: an integrative systematic literature review.BMC health services research · 2022Pooled it
- Identifying and understanding benefits associated with return-on-investment from large-scale healthcare Quality Improvement programmes: an integrative systematic literature review.BMC health services research · 2022Pooled it
- Factors influencing the formation of balanced care teams: the organisation, performance, and perception of nursing care teams and the link with patient outcomes: a systematic scoping review.BMC health services research · 2024Article
- The feasibility and validity of using a real time location system (RTLS) to measure bedside contact time.Journal of research in nursing : JRN · 2022Article
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Authors and funding
10 authors.
Funding
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Abstract
backgroundImproving the quality and efficiency of healthcare is an international priority. A range of complex ward based quality initiatives have been developed over recent years, perhaps the most influential programme has been Productive Ward: Releasing Time to Care. The programme aims to improve work processes and team efficiency with the aim of 'releasing time', which would be used to increase time with patients ultimately improving patient care, although this does not form a specific part of the programme. This study aimed to address this and evaluate the impact using recent methodological advances in complex intervention evaluation design.
methodThe objective of this study was to assess the impact of an augmented version of The Productive Ward: Releasing Time to Care on staff and patient outcomes. The design was a naturalistic stepped-wedge trial. The setting included fifteen wards in two acute hospitals in a Scottish health board region. The intervention was the Productive Ward: Releasing Time to Care augmented with practice development transformational change methods that focused on staff caring behaviours, teamwork and patient feedback. The primary outcomes included nurses' shared philosophy of care, nurse emotional exhaustion, and patient experience of nurse communication. Secondary outcomes covered additional key dimensions of staff and patient experience and outcomes and frequency of emergency admissions for same diagnosis within 6 months of discharge.
resultsWe recruited 691 patients, 177 nurses and 14 senior charge nurses. We found statistically significant improvements in two of the study's three primary outcomes: patients' experiences of nurse communication (Effect size=0.15, 95% CI; 0.05 to 0.24), and nurses' shared philosophy of care (Effect size =0.42, 95% CI; 0.14 to 0.70). There were also significant improvements in secondary outcomes: patients' overall rating of ward quality; nurses' positive affect; and items relating to nursing team climate. We found no change in frequency of emergency admissions within six months of discharge.
conclusionsWe found evidence that the augmented version of The Productive Ward: Releasing Time to Care Intervention was successful in improving a number of dimensions of nurse experience and ward culture, in addition to improved patient experience and evaluations of the quality of care received. Despite these positive summary findings across all wards, intervention implementation appeared to vary between wards. By addressing the contextual factors, which may influence these variations, and tailoring some elements of the intervention, it is likely that greater improvements could be achieved. TRIAL REGISTRATION NUMBER: UKCRN 14195.
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