Workforce redesign: A quality improvement project to develop and implement a bespoke instrument to match patients’ needs to skill mix in NHS Lothian

McAuley, Gillian; Seville, Lorna; Corcoran, Janet; Forrest, Stephen; Sharp, Sandra

Abstract

Nursing workforce shortages impact care delivery. Effective delegation of tasks is one solution to ensure that all healthcare professionals work to their full scope of practice to deliver person-centred care. Workforce redesign can be an effective method to facilitate this. We report on the design and implementation of a bespoke instrument to objectively measure patient needs and nursing activity to identify care interventions that may be suitable for delegation to non-registered staff. Following the development of a bespoke tool, the project team completed more than three hundred hours of observations (321 hours and 58 minutes). Observations occurred at the patient's bedside, and the care activity was recorded, as well as the role of undertaking the activity. Focusing on registered nursing activity, forty-one (41) of the sixty-four (64) coded categories were tasks and activities that were potentially suitable for delegation to non-registered nursing roles. The criteria and suitability varied, with some tasks and activities requiring specific additional training, and others having no particular training requirement. During the observation period the total sum of observed tasks deemed suitable for delegation equated to over fifty-four (54) hours, which is over half of the total observed hours for Registered Nursing staff, freeing up registered nurses to undertake tasks only they can do. This work demonstrates how proactive steps can be taken to redesign the healthcare workforce to benefit staff and patients.

Citation

McAuley, G., Seville, L., Corcoran, J., Forrest, S., & Sharp, S. (online). Workforce redesign: A quality improvement project to develop and implement a bespoke instrument to match patients’ needs to skill mix in NHS Lothian. Health Policy OPEN, https://doi.org/10.1016/j.hpopen.2024.100133

• Journal Article Type: Article
• Acceptance Date: Nov 23, 2024
• Online Publication Date: Dec 5, 2024
• Deposit Date: Dec 2, 2024
• Publicly Available Date: Dec 6, 2025
• Electronic ISSN: 2590-2296
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• DOI: https://doi.org/10.1016/j.hpopen.2024.100133
• Publisher URL: https://www.sciencedirect.com/journal/health-policy-open