Rehab MATRIX: Impact of a Nursing-Led Acuity Algorithm on Patient Safety and Healthcare Quality

Study Overview
=================
Brief Summary
-----------------
To determine whether implementation of Rehab MATRIX will improve patient safety, patient satisfaction and nursing indices.

Detailed Description
-----------------
The provision of efficient and conscientious nursing care is at the forefront of health care quality. Unfortunately, a lack of objectivity in the assignment of patients to nurses can lead to inequalities of care. Such inequalities translate to poor patient outcomes and diminished patient satisfaction. Furthermore, staff attrition related to nursing fatigue increases the cost of care due to a reliance on supplemental nurses. Rehab MATRIX is a patient assignment tool that objectively categorizes patients undergoing inpatient rehabilitation based on nurse identified acuity variables.

Official Title
-----------------
Rehab MATRIX: Impact of a Nursing-Led Acuity Algorithm on Patient Safety and Healthcare Quality

Conditions
-----------------
Nurse's Role, Nurse-Patient Relations, Satisfaction, Patient Fall

Intervention / Treatment
-----------------
* Other: Rehab MATRIX


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Rehabilitation Nursing Staff within Six Study Centers Patient hospitalized within the Rehabilitation Unit during the study period Exclusion Criteria: Other Nursing Staff Patients hospitalized on non-rehabilitation units
Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Health Services Research
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Rehab MATRIX<br>Rehab MATRIX is a patient assignment tool that objectively categorizes patients undergoing inpatient rehabilitation based on nurse identified acuity variables. | Other: Rehab MATRIX<br>* Rehab MATRIX is a patient assignment tool that objectively categorizes patients undergoing inpatient rehabilitation based on nurse identified acuity variables.<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in the number of falls per 1000 patient days (falls per 100 patient days is a standardized proportion) |  | Baseline, 1 month, 2 months, 3 months, 4 months, 5 months, 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Patient Satisfaction as assessed by the Press Ganey Survey |  | Baseline, 1 month, 2 months, 3 months, 4 months, 5 months, 6 months | 
| Change in Nursing Fatigue as assessed by number of unexcused nurse absences |  | Baseline, 1 month, 2 months, 3 months, 4 months, 5 months, 6 months | 
| Change in Nursing Satisfaction as assessed by a survey | Two weeks prior to Rehab MATRIX initiation, a six question pre-implementation survey will be distributed via Survey Monkey to the nursing staff, evaluating nurse perceptions of the traditional nursing assignment. Questions 1 to 4 will be measured on a Likert Scale of 1 to 5; 1 - strongly disagree, 2 - disagree, 3 - neutral, 4 - agree, 5 - strongly agree. At the end of the six month study period, a post-implementation Rehab MATRIX survey will be distributed at each center via Survey Monkey, examining the impact of Rehab MATRIX on workload equity, fairness, the role of seniority and overall satisfaction with the nurse assignment process. | Two weeks prior to initiation, 6 months |