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Getting your arms around the topic of evidence-based staffing is not simple. This is difficult for a number of reasons, not the least of which is the lack of an accepted definition of evidence-based staffing; what exactly does it mean? Even if we set politics and the lobbying of different interest groups aside, gaining agreement on something that has such far-reaching implications and which impacts so many stakeholders would not be easy.
Nursing departments across the country are using various types of benchmarks and data to set nursing budgets and staffing productivity targets. Some include Solucient, Premier, Labor Management Institute, NDNQI, and historical internal data. The lack of one widely accepted benchmarking methodology makes it difficult to compare productivity across organizations. There are also issues related to Finance departments using one methodology for benchmarking and nursing subscribing to another, or not having confidence in the methodology used by Finance.
What has been your experience with benchmarking? What do you use? Does it have credibility with Finance? Does it have credibility with nursing staff?
Another thing that is included in proposed staffing legislation is a requirement for a patient acuity system. However, very few hospitals currently use patient acuity systems. In a recent study in Pennsylvania, less than 20% of hospitals were using patient acuity systems, down from over 40% ten years ago. Key reasons cited for discontinuing the use of patient acuity are problems with validity, reliability, time and cost involved, and the fact that the data lacked credibility with staff.
What are your thoughts on patient acuity systems?
Many states are considering staffing legislation, which frequently includes a requirement for a Staffing Committee comprised of 50% direct care staff. If you are in one of those states and have a staffing committee, it would be helpful to know how your committee is structured, how has the committee helped or hindered you in achieving staff engagement in staffing decisions, and what you would recommend to others considering the introduction of a staffing committee.
You comments and experiences will be greatly appreciated.
If you could invent something new that would propel the world of healthcare staffing forward, what would it be?
“The world of healthcare staffing is complex, multi-facetted and the implications of staffing are far reaching, touching almost every aspect of healthcare. If we open our minds, leverage experience and ideas from across disciplines, facilities and geographies we can uncover new approaches to staffing that can better serve our future”
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