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The impact of rationing of health resources on capacity of Australian public sector nurses to deliver nursing care after‐hours: a qualitative study
Author(s) -
Henderson Julie,
Willis Eileen,
Toffoli Luisa,
Hamilton Patricia,
Blackman Ian
Publication year - 2016
Publication title -
nursing inquiry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.66
H-Index - 49
eISSN - 1440-1800
pISSN - 1320-7881
DOI - 10.1111/nin.12151
Subject(s) - rationing , nursing , qualitative research , public sector , public health , health care rationing , medicine , health sector , health care , business , environmental health , political science , economic growth , health services , sociology , economics , social science , population , law
Australia, along with other countries, has introduced New Public Management (NPM) into public sector hospitals in an effort to contain healthcare costs. NPM is associated with outsourcing of service provision, the meeting of government performance indicators, workforce flexibility and rationing of resources. This study explores the impact of rationing of staffing and other resources upon delivery of care outside of business hours. Data was collected through semistructured interviews conducted with 21 nurses working in 2 large Australian metropolitan hospitals. Participants identified four strategies associated with NPM which add to workload after‐hours and impacted on the capacity to deliver nursing care. These were functional flexibility, vertical substitution of staff, meeting externally established performance indicators and outsourcing. We conclude that c ost containment alongside of the meeting of performance indicators has extended work traditionally performed during business hours beyond those hours when less staffing and material resources are available. This adds to nursing workload and potentially contributes to incomplete nursing care.