Costing out nursing: combining PCSs (patient classification systems), DRGs, and standards of care

Perhaps the greatest challenge hospitals face today is simultaneously providing high-quality care and containing costs. To meet this challenge, nursing services must master the ability to accurately project staffing that guarantees high-quality care within justifiable cost limits. Nursing is an important cost center in hospitals; therefore, it is necessary to extract nursing care costs from room and board costs. By establishing a PCS and a set of standards of care for each DRG category, nurse administrators can control nursing staff ratios while ensuring quality care, therefore, effectively and efficiently using their nursing resources. This study suggests that direct nursing care can be delivered to meet the patient care needs within the DRG trim points and that by delivering care according to a set of standards, nursing care costs can be determined for a specific group of patients. These findings assist the nurse administrator in establishing control measures and setting resource allocation priorities.