PMID- 24696673
OWN - NLM
STAT- MEDLINE
DCOM- 20140929
LR  - 20211021
IS  - 1612-3174 (Electronic)
IS  - 1612-3174 (Linking)
VI  - 12
DP  - 2014
TI  - Monitoring the impact of the DRG payment system on nursing service context 
      factors in Swiss acute care hospitals: Study protocol.
PG  - Doc07
LID - 10.3205/000192 [doi]
LID - Doc07
AB  - AIMS: With this study protocol, a research program is introduced. Its overall aim 
      is to prepare the instruments and to conduct the first monitoring of nursing 
      service context factors at three university and two cantonal hospitals in 
      Switzerland prior to the introduction of the reimbursement system based on 
      Diagnosis Related Groups (DRG) and to further develop a theoretical model as well 
      as a methodology for future monitoring following the introduction of DRGs. 
      BACKGROUND: DRG was introduced to all acute care hospitals in Switzerland in 
      2012. In other countries, DRG introduction led to rationing and subsequently to a 
      reduction in nursing care. As result, nursing-sensitive patient outcomes were 
      seriously jeopardised. Switzerland has the opportunity to learn from the 
      consequences experienced by other countries when they introduced DRGs. Their 
      experiences highlight that DRGs influence nursing service context factors such as 
      complexity of nursing care or leadership, which in turn influence 
      nursing-sensitive patient outcomes. For this reason, the monitoring of nursing 
      service context factors needs to be an integral part of the introduction of DRGs. 
      However, most acute care hospitals in Switzerland do not monitor nursing service 
      context data. Nursing managers and hospital executive boards will be in need of 
      this data in the future, in order to distribute resources effectively. 
      METHODS/DESIGN: A mixed methods design in the form of a sequential explanatory 
      strategy was chosen. During the preparation phase, starting in spring 2011, 
      instruments were selected and prepared, and the access to patient and nursing 
      data in the hospitals was organized. Following this, online collection of 
      quantitative data was conducted in fall 2011. In summer 2012, qualitative data 
      was gathered using focus group interviews, which helped to describe the processes 
      in more detail. During 2013 and 2014, an integration process is being conducted 
      involving complementing, comparing and contrasting quantitative and qualitative 
      findings. CONCLUSION: The research program will produce baseline data on nursing 
      service context factors in Swiss acute care hospitals prior to DRG introduction 
      as well as a theoretical model and a methodology to support nursing managers and 
      hospital executive boards in distributing resources effectively. The study was 
      approved by the ethics committees of Basel, Bern, Solothurn and Zurich.
FAU - Spirig, Rebecca
AU  - Spirig R
AD  - Department of Nursing and Allied Health Care Professions, University Hospital 
      Zurich, Switzerland ; Institute of Nursing Science, University of Basel, 
      Switzerland.
FAU - Spichiger, Elisabeth
AU  - Spichiger E
AD  - Institute of Nursing Science, University of Basel, Switzerland ; Directorate of 
      Nursing, Medical-Technical and Medical-Therapeutic Areas, Inselspital, Bern 
      University Hospital, Bern, Switzerland.
FAU - Martin, Jacqueline S
AU  - Martin JS
AD  - Department of Nursing and Allied Health Professions, University Hospital Basel, 
      Switzerland.
FAU - Frei, Irena Anna
AU  - Frei IA
AD  - Practice Development Unit, Department of Nursing and Allied Health Professions, 
      University Hospital Basel, Switzerland.
FAU - Muller, Marianne
AU  - Muller M
AD  - Institute of Data Analysis and Process Design, School of Engineering, Zurich 
      University of Applied Sciences, Winterthur, Switzerland.
FAU - Kleinknecht, Michael
AU  - Kleinknecht M
AD  - Department of Nursing and Allied Health Care Professions, University Hospital 
      Zurich, Switzerland.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20140327
PL  - Germany
TA  - Ger Med Sci
JT  - German medical science : GMS e-journal
JID - 101227686
SB  - IM
MH  - Adult
MH  - Attitude of Health Personnel
MH  - Critical Care Nursing/economics/*statistics & numerical data
MH  - Diagnosis-Related Groups/*economics/statistics & numerical data
MH  - Female
MH  - Health Care Rationing/*economics/statistics & numerical data
MH  - Humans
MH  - *Job Satisfaction
MH  - Male
MH  - Middle Aged
MH  - Nursing Service, Hospital/*economics/statistics & numerical data
MH  - Practice Patterns, Nurses'/*economics/statistics & numerical data
MH  - Switzerland
MH  - Workload/economics/*statistics & numerical data
MH  - Young Adult
PMC - PMC3972437
OTO - NOTNLM
OT  - DRG
OT  - nursing monitoring
OT  - nursing service context factors
EDAT- 2014/04/04 06:00
MHDA- 2014/09/30 06:00
PMCR- 2014/03/27
CRDT- 2014/04/04 06:00
PHST- 2013/11/08 00:00 [received]
PHST- 2014/03/17 00:00 [revised]
PHST- 2014/04/04 06:00 [entrez]
PHST- 2014/04/04 06:00 [pubmed]
PHST- 2014/09/30 06:00 [medline]
PHST- 2014/03/27 00:00 [pmc-release]
AID - 000192 [pii]
AID - 10.3205/000192 [doi]
PST - epublish
SO  - Ger Med Sci. 2014 Mar 27;12:Doc07. doi: 10.3205/000192. eCollection 2014.