In this issue we explore the question how to create environments that in parallel support the best possible outcomes for patients and create the type of environments where caregivers can thrive. To accomplish this, we looked to two experts on this topic - Rebecca Hathaway, MSN, RN, EDAC, Senior VP Healthcare, MMC Architects and Susan Burks, Owner, Burks Consulting Group.

When it comes right down to it, no matter how modern, sophisticated, or efficient staffing programs are, if the individuals who are executing the care are not qualified, engaged, and able to offer the caring necessary for healing, the whole system can unravel quickly. At its very essence staffing works because of the people who are staffed.

The challenges before us in health care staffing are big, but they will never be solved by the application of symptom-level solutions. Health care staffing is a complicated arena, and nurses are in the best position to assure a good match between the problems being addressed and the solutions being adopted.

While the call for data-driven staffing is loud and even overdue, our approach to it must be harmonized with the human side as well. Discovering the right combination of hard data and soft data may well be the impetus needed to catapult a shift in how we approach staffing to new levels of effectiveness.

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 confi

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.

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.

If you could invent something new that would propel the world of healthcare staffing forward, what would it be?