A structured evidence-based literature review regarding the effectiveness of improvement interventions in clinical handover

Paperwork is a major source of frustration for hospital nurses and takes valuable time away from patient care. Studies indicate that nurses spend an estimated 13% to 28% of total shift time documenting. The growth in documentation requirements for nurses can, in part, be attributed to an exponential rise in health system complexity. Authors explore the documentation of nursing care plans from a complex adaptive system perspective and then analyze the utility of adopting a standardized nursing language. An actual case history of a nursing unit's attempt to reduce complexity, improve completion time, and increase staff satisfaction in care planning by adopting a standardized nursing language is provided to emphasize a practical application.

The benefits of standardized nursing languages in complex adaptive systems such as hospitals.

Care Across the Continuum: Access to Health Care Services in Rural America

........................................................ i Acknowledgements ........................................... iii Table of

Histories of Chest Pain: history of the presenting complaint as recorded by different health care providers of patients presenting to a rural hospital with suspected acute myocardial infarction

The National Centers of Excellence in Women's Health Program (CoE) represents a new model for women's health in academic health centers that unites women's health research, teaching, clinical care, public education and outreach, and career advancement for women in the health sciences. Lessons learned from the first 3 years of implementation indicate that this type of model requires a transformation from the traditionally fragmented set of activities in academic health centers to an integrated system united around the goal of advancing women's health. The transformation requires institutional commitment, dedicated players, and an ability to build on existing resources and bring added value to the institution. Challenges and strategies to link women's health activities and increase collaboration are also discussed.

Implementing a new model of integrated women's health in academic health centers: lessons learned from the National Centers of Excellence in Women's Health.

An increased emphasis on integrated care delivery and the need to access information across the care continuum led to an assessment and modification of the current documentation system at Summa Health System in Akron, Ohio. The goal was to achieve more complete and concise interdisciplinary charting. This article describes the process the two-hospital system developed to achieve integrated documentation reflecting the patient's progress toward team-defined outcomes. Steps in the evaluation and modification of the old system, lessons learned, and results/implications for quality improvement are shared.

Weakland R

Papers

Designing interdisciplinary documentation for the continuum of care.