The Relationship between Nursing Unit Design, Communication and Teamwork among Care Providers, and Quality of Care
Cayuga Medical Center Phase 1:
This study examined the relationships among physical design and communication patterns, job stress and job satisfaction, and teamwork and collaboration among multi-disciplinary care providers. Data was collected in a pre-post research design comparing a more decentralized vs. a more centralized nursing station layout of an ICCU on unplanned, opportunistic communication and interaction patterns among, job stress, teamwork, and job satisfaction. Data collection included two forms of systematic observation (behavior mapping and shadowing of nurses); a survey among nurses of teamwork, job stress, and job satisfaction; and interviews. Results showed a dramatic reduction in interactions in the new decentralized ICCU as compared to the original more centralized nursing unit layout. Nurses moved constantly among all the decentralized nursing pods on the unit. Job stress increased and job satisfaction and teamwork decreased. In the face of an increasing preference for decentralization in nursing unit layout these findings suggest the need for a more thorough analysis of their costs and benefits for a range of valued patient and staff outcomes. Because these data were collected within three months of the move to the new facility, a second study was initiated (see CMC Phase 2, below) to assess the effects of the move to the new, more decentralized facility after more than a year.
Vilacorte, A. (2008) The changing healthcare workplace: An exploratory case study of decentralized nursing layouts. Unpublished Master’s thesis, Cornell University.
Dutta, R. (2008) Influence of nursing unit layout on staff communication and interaction patterns. Unpublished Master’s thesis, Cornell University.