MEASURING AND EVALUATING HOSPITAL RESTRUCTURING EFFORTS - 18-MONTH FOLLOW-UP AND EXTENSION TO CRITICAL CARE, PART 1

Increasingly, hospital restructuring is viewed with skepticism because of a lack of systematic and rigorous evaluation of its impact on qual ity of care. This first article in a two-part series describes compreh ensive evaluation of the effects of hospital restructuring on patient satisfaction, nurse satisfaction, costs of care, and clinical quality on four medical-surgical units at a large tertiary hospital. In additi on, early application of the model to critical care is described. A qu asiexperimental pre- and post-design combined with concurrent control units for selected measures was the overall strategy,The authors concl ude that comprehensive restructuring of hospital-based care can take p lace in a manner that preserves multiple dimensions of quality while d ecreasing costs. This only can be ascertained, however, through rigoro us and systematic measurement and evaluation. Part 2 will detail appli cation and evaluation of the restructuring model in the critical care environment.