To meet the changing dynamics of medical care, The Good Samaritan Hospital has created a dedicated, 15-bed observation/extended recovery unit for patients. In addition, Good Samaritan will also move to a registered nurse model for medical/surgical nursing floors and the emergency department. Both moves are designed to improve the quality of patient care in the hospital.
In addition to promoting quality patient care, the changes also allow the hospital to adapt to an economic environment that has changed during the recession. Hospital admission rates have declined overall nationally. At The Good Samaritan Hospital, admission rates dropped by six percent between fiscal years 2008 and 2009. To ensure that hospital resources are used wisely, Good Samaritan evaluated patient service and staffing patterns to find ways to adjust to current economic conditions.
Observation units are necessary because some patients arrive at the hospital too sick to be sent home, yet not sick enough to meet insurance criteria for admission to the hospital. The observation unit gives physicians an opportunity to keep patients in the hospital for a longer period of time to make a more thorough diagnosis. Observation patients usually stay for one day or less. The additional time is used for testing and evaluation, providing the physician with more information to make a decision on the best course of treatment for an individual patient.
“In the past, physicians would have simply admitted patients to the hospital that now fit under the standards used for observation patients,” said Vice President, Nursing Services, Jacquelyn Gould. “The need is growing. In fiscal year 2008, the hospital treated 1,404 observation patients. In fiscal year 2009, the hospital treated 1,806 observation patients – or a more than 400 patient jump between the last two years alone.”
As the new observation unit opens, Good Samaritan will also transition to a registered nurse (RN) model of nursing care for medical/surgical floors and the emergency department. The hospital has converted 32 licensed practical nurse (LPN) positions into RN positions. The hospital has notified the LPNs of the transition. The LPNs will be offered severance packages and outplacement assistance.
“The registered nurse model provides several advantages for patients,” Gould explained. “Because they receive a higher level of training, RNs can provide a variety of services that LPNs cannot offer. For example, sometimes drugs are administered through the intravenous tube in a process called an IV push. An LPN is not allowed to provide an IV push, so she would need to find an RN to do it. By using the RN model, all nurses are ready to perform all nursing tasks. This should provide a more efficient patient care environment.”
Vice President for Strategic Planning and Marketing William Mulligan explained that hospital admission rates affected the timing of the action. “Many hospitals around the region and country have adopted an RN nursing model. We made the decision to move now because it also helps us align nursing staff to current patient needs. As more people have decided to delay care during the recession, we have worked to find ways that we can be more efficient and cost-effective. Because RNs have the training to provide a variety of patient care services, this transition allows us to contain costs, ensure proper nurse patient ratios and deliver a high quality of patient care,” Mulligan said.
The transition to the registered nurse model is focused on the medical/surgical floors and the emergency room. The Good Samaritan Health System does continue to employ licensed practical nurses in other areas of the hospital, physician practice offices and off-site treatment areas where LPN skills are best matched for quality patient care.
For 120 years, the Good Samaritan Health System (www.gshleb.org) has served the health care needs of Lebanon County. The Good Samaritan Hospital is a modern, fully-equipped, fully-accredited 172-bed acute care facility that offers complete inpatient and outpatient care, as well as an inpatient rehabilitation program. The health system also provides services at many other sites located throughout Lebanon County.