English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Zendy Plus

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Zendy Tools

Zendy Open

Patient admissions, discharges, and transfers are high work demand activities that have been associated with 30-day readmissions and increased patient mortality. Most mitigation strategies target peak demand, but variable demand may be more significant. Self-organizing holarchic open systems (SOHOs) and resilience engineering frameworks may explain system behavior, but a few quantitative studies of resilient organizational performance have been published. We used three measures to explore SOHO and resilience engineering constructs. We collected hourly data over 2 years, from five inter-related units in a cardiovascular disease division of a metropolitan teaching hospital. Our results show that information flows (inbound, outbound, answered, and unanswered telephone calls) representing anticipatory management are related to patient flows (patient admissions discharges and transfers) and nurse-staffing levels (nurse-to-patient ratios). We also found overall system stability despite high patient flow effects in lower level units. Unexpectedly, the time to recovery from high patient flow events lasted up to 7 days. We conclude that constructs proposed by resilience engineering can be quantified using simple measures collated within routine operations. The application of nonlinear statistical analyses can uncover important insights about resilient performance that may assist managers in better preparing for managing and recovering from unexpected variation in patient flow.

Using telephone call rates and nurse-to-patient ratios as measures of resilient performance under high patient flow conditions