Tracing the missing link between nursing workload and case mix groups: a validation study

This paper reports on the creation of a nursing workload data base of over 40,000 inpatient records by the Hospital Medical Records Institute (HMRI). During the 1989-90 fiscal year, five Ontario hospitals (four teaching, one community) reported total hours of nursing on the HMRI abstract along with standard clinical and demographic information. The accuracy of nursing workload data varied across hospitals and seemed to reflect differences in how data collection was implemented. When the data base was grouped by Case Mix Groups (CMGs), analysis demonstrated that patterns of resource utilization in nursing workload and length of stay were similar across CMGs. Results of this analysis indicate that the nursing workload component of the Resource Intensity Weight may be useful for estimating a hospital's nursing costs by CMG.