Rehab MATRIX: Content Validity of a Nursing-Led Patient Assignment Algorithm.

Abstract

The provision of conscientious nursing care is at the forefront of health quality. Unfortunately, a lack of standardization in the assignment of patients to nurses can lead to care inequities. Rehab MATRIX is a nursing-led tool that equitably assigns patients using select acuity variables. In this initial study, we asked focus groups of 19 registered nurses and 8 patient care assistants to identify medical interventions that increase the effort of nursing care at a 24-bed inpatient rehabilitation facility (IRF). This IRF is affiliated with a comprehensive heart and vascular institute, a level I trauma center, and a The Joint Commission (TJC) Comprehensive Stroke Center. Thirteen acuity variables were included in the Rehab MATRIX patient assignment grid. High-acuity patients with greater than 6 variables were color-coded "red," medium-acuity patients with 3 to 5 variables were color-coded "yellow," and low-acuity patients with less than 3 variables were color-coded "green." Each registered nurse and patient care assistant were assigned an equitable number of red-, yellow-, and green-coded patients per shift. New admissions were Rehab MATRIX color-coded during nursing report and assigned objectively. Nursing staff at a wide-ranging IRF created Rehab MATRIX, an equitable patient assignment tool, representative of nursing effort needed to provide quality care. Nursing-led patient assignment tools increase autonomy and provide the opportunity for all nursing staff to influence healthcare practice. These factors may lead to increased nursing satisfaction and decreased burnout.