Evaluating Skill-Mix Models of Care

Abstract

OBJECTIVE To synthesize the literature on measures and outcomes for skill-mix models of care. BACKGROUND To address the human health resource crisis, changes to skill mix within models of care are being implemented emphasizing the need to synthesize evaluation methods for skill-mix models in the future. METHODS A scoping review of the literature using a rigorous search strategy and selection process was completed to identify articles that examined skill-mix models in an effort to identify related concepts. RESULTS Ten studies examined skill-mix models. Areas of measurement in assessing the impact of skill-mix models included patient outcomes, patient satisfaction, nurse satisfaction, cost, and nurse perceptions of role changes, model effectiveness, and quality of care. Studies examining nurse satisfaction, patient satisfaction, and/or cost generally reported improvements upon skill-mix model implementation. Studies examining patient outcomes related to skill mix were inconsistent. CONCLUSIONS Factors for consideration upon implementation of a skill-mix change include education of role clarity, the number of unregulated staff who require supervision, and professional practice support.