Marshall R D, Spencer R I
Br Med J. 1974 Jul 6;3(5922):27-30. doi: 10.1136/bmj.3.5922.27.
Faced with a shortage of trained nursing staff and a high wastage rate among learners the management of a district general hospital decided to close some of its acute beds. A beds committee attempted to minimize the effects of these closures by introducing a bed bureau, "pooling," and a simple system for forecasting waiting list admissions.The figures for recruitment and wastage of nurses improved, and a very high turnover per available bed was achieved. This increased efficiency in numerical terms was not mirrored by an improvement in the morale of the doctors and nurses working on the wards, who were subjected to new pressures and considered that at times the standard of patient care deteriorated.
面对训练有素的护理人员短缺以及学员流失率高的问题,一家地区综合医院的管理层决定关闭部分急症病床。一个病床委员会试图通过引入病床管理局、“集中调配”以及一个简单的预测候诊名单入院情况的系统,来尽量减少这些关闭措施的影响。护士的招聘和流失数据有所改善,每张可用病床的周转率非常高。从数字上看,这种效率的提高并没有反映在病房医护人员士气的提升上,他们承受着新的压力,并且认为有时患者护理标准下降了。