Aim: To systematically review and evaluate the literature on the impact of self-scheduling on patient, nurse and organization-related outcomes.
Design: A systematic review.
Data sources: PubMed, Embase, Web of Science, Cinahl, Scopus, Google Scholar, ERIC and Cochrane Library were screened until October 2019 (week 40) for peer-reviewed, empirical articles, written in English, Dutch or French.
Review methods: Two reviewers screened title and abstract using predetermined eligibility criteria and one reviewer screened the full texts of relevant hits. Quality was assessed with the Mixed Methods Appraisal Tool.
Results: Studies (N = 23) were retained and classified into explanatory and descriptive studies. The articles reported on a range of outcomes: patient- and nurse-reported quality of care, job satisfaction, satisfaction with scheduling, work/life balance, planning involvement, interaction with colleagues, health and well-being, psychosocial factors, professional development, nurse manager's scheduling time, general working conditions, turnover, temporary employment agency use and absenteeism, recruitment and retention.
Conclusion: The evidence base is limited. Several studies confirmed the positive impact of self-scheduling on the nurse and the organization. However, other studies found negative outcomes or no change. These outcomes should be interpreted in the light of contextual factors and the implementation process, which was often not without difficulties. Future research should use a multimethod longitudinal design, bear in mind the possibilities of quantitative research (e.g. for studying psychosocial factors) and employ a theoretical framework.
Impact: This review informs about the inconsistent evidence on the association between self-scheduling and patient, nurse and organization-related outcomes and includes enablers and barriers to a successful implementation. These outcomes are influenced by the implementation process and the sustainability of the self-scheduling system, which are still major challenges for healthcare management. This demonstrates the urgent need for further research.
目标: 对有关于自我排班法对患者、护士和医院组织相关结果影响的文献进行系统性地回顾和评估。 设计: 系统性回顾。 数据来源: 筛选出国际文献数据库(PubMed)、荷兰医学文摘数据库(Embase)、科学网(Web of Science)、护理学数据库(CINAHL)、Scopus电子数据库、谷歌学术搜索(Google Scholar)、科教资源信息中心(ERIC)和Cochrane临床对照试验中心注册数据库2019年10月(第40周)前经同行评议的、以英语、荷兰语或法语撰写的实证论文。 评价方法: 两名评审员使用预先确定的资格标准筛选标题和摘要,一名评审员筛选相关点击的全文内容。采用混合方法评价工具评价论文质量。 结果: 将研究(N=23)文章保留下来,并分为解释性研究和描述性研究。文章报告了一系列结果:患者和护士报告的护理质量,工作满意度,排班的满意度,工作和生活的平衡,计划的参与性,与同事的互动,健康和幸福感,社会心理因素,职业发展,护士长的排班时间,一般工作条件,人员流动,短工介绍所的用途以及旷工、招聘和留用。 结论: 可循证的资料不多。一些研究证实了自我排班对护士和医院组织具有积极的影响。但另一些研究提出其会带来负面结果或完全没有变化的发现结果。这些结果应根据背景因素和实施过程做出解释,但时常不是一件轻而易举的事。未来的研究应采用多元法纵向设计,谨记可否采用定量研究(例如研究心理社会因素),以及使用理论框架。 影响: 本篇评价文章说明了自我排班与患者、护士和医院组织相关结果之间关联性的矛盾证据,包括成功实施自我排班的促进因素和阻碍因素。这些结果会受到实施过程和自我排班体制可持续性的影响,这些仍是医疗管理面临的主要挑战。这一点表明需要做进一步研究的迫切需求。.
Keywords: flexible scheduling; healthcare; implementation; literature review; nurse; nursing assistant; organization; outcome; patient; self-scheduling; systematic review.
© 2020 John Wiley & Sons Ltd.