Grant: Partnerships for Health System Improvement (PHSI)

Time and workload pressures experienced by hospital nurses often result in their having insufficient time to complete their work in providing care for patients. This situation can adversely affect nurses' job satisfaction and patient outcomes. Although the mechanisms are not completely understood, the quality and efficiency of the work environment can impact nurses' ability to spend time performing direct patient care. The Saskatchewan Health Quality Council and The Change Foundation in Ontario are supporting the implementation, in their provinces, of a patient-centered, nurse-led health care improvement initiative developed in England by the National Health Service. This initiative, called Releasing Time to Care-The Productive Ward (RTC), incorporates key concepts of empowerment, engagement, leadership, teamwork and rapid cycle improvements in structured modules that hospital unit nursing teams use to guide their improvement of their work environment and care processes. Although RTC has been widely used in the United Kingdom, New Zealand and Australia, this study will be the first to rigorously evaluate the impact of RTC. Over the study period (April 2010-March 2013), RTC will be implemented on 33 hospital units (20 hospitals) in Saskatchewan and 10 units (10 hospitals) in Ontario. The research will evaluate whether nurses' use of RTC results in improved patient outcomes (e.g., improved satisfaction; reduced readmissions to hospital) and improvements to the quality of nurses' worklife (e.g., improved job satisfaction; reduced sick time). The project will involve detailed analyses of data from provincial hospital and health human resource databases, patient and nurse surveys, interviews of nurses and health care leaders, and analysis of relevant policy and procedures documents from hospitals. The project team includes researchers and health care policy and decision-makers to ensure the relevance of the research and its dissemination to each of those audiences.