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From the Frances Payne Bolton School of Nursing, Case Western Reserve Unfi:emity, Cleveland, OH.

Mary L. McHugh, PhD, RN: Assistant Professor of Nursing, Frances Payne Bolton School of Nursing, Case Western Re- serve University, Cleveland, OH.

Address reprint requests to Mary L. McHugh, PhD, RN, Assistant Professor, Frances Payne Bolton School of Nursing, Case Western University, 2121 Abington Rd, Cleveland, OH 44106.

© 1989 by W.B. Saunders Company. 0897.1897189/0202-0011505.00/0

Sources of Inefficiency: Questions

F. Theodore Helmer and Shirley F. Olson

S OME of the keys to increased efficiency come from the following questions:

• Can some of the nursing tasks accomplished during the day and evening shifts be switched to the night shifts? Is there a balance between shifts? Are the proper number of nurses sched- uled?

• Can the unit increase the number or skill levels of the clerical staff to relieve the more expensive RNs of routine tasks?

• Is the cost of a higher skill mix cost-effective

CLINICAL METHODS

when unit objectives and the efficiencies of the nursing unit are reviewed?

• Are nurses spending too much time in house- keeping duties that might be done less expen- sively by increasing the housekeeping staff?.

• Are the nurses running too many errands? • Can paperwork be streamlined or not completed

at all? • Are all meetings cost-effective? • Why is the shift report so long? • Can greater use be made of volunteers? • Can any established policies or procedures be

changed to influence efficiency? • Can the layout of the ufiit be modified to save

steps and time? • Is the cost of additional training supported by

increased efficiency of the nurses? Are in- services given during slow periods on slow days?

• Are the staff spending their time properly? • Are the patient assignments made with effi-

ciency in mind?

From the College of Business, Northern Arizona University, Flagstaff, and Else School of Management, Millsaps College, Jackson, MS.

F. Theodore Helmer, PhD: Associate Professor, College of Business, Northern Arizona University, Flagstaff; Shirley F. Olson, DBA: Associate Professor, Else School of Management, Millsaps College, Jackson, MS.

Address reprint requests to F. Theodore Helmer, PhD, As- sociate Professor, College of Business, Northern Arizona Uni- versity, NAU Box 15066, Flagstaff, AZ 86011.

© 1989 by W.B. Saunders Company. 0897-1897189/0202.0012505.00/0