Implementing a DRG-driven acuity system for nurse staffing under prospective hospital payment

Area of Science:

• Healthcare Management
• Nursing Informatics
• Health Economics

Background:

• Prospective payment systems, such as Diagnosis Related Groups (DRGs), necessitate efficient management of nursing resources.
• Traditional nursing management tools may not adequately address the complexities of DRG-based reimbursement.

Purpose of the Study:

• To introduce a microcomputer software, the DRG-Nursing Unit Manager, designed for effective nursing management within a DRG prospective payment environment.
• To present a versatile and user-friendly tool for nursing departments to optimize resource allocation and financial performance.

Main Methods:

• Development of multifunctional microcomputer software for IBM-PC-XT.
• Implementation of features for patient demographics entry, MDC/DRG assignment, and data retrieval.
• Integration of nursing measures, length of stay norms, and reporting capabilities.

Main Results:

• The system provides a patient census with expected nursing intensities, enabling staffing projections for upcoming shifts.
• It facilitates the costing of nursing services and generates charge-equivalent statistics, enabling nursing stations to function as revenue centers.
• The software aids in identifying DRGs that are financially advantageous or disadvantageous under routine care costs.

Conclusions:

• The DRG-Nursing Unit Manager is a significant management tool for nursing departments operating under DRG prospective payment.
• Its simplicity and versatility enhance operational efficiency and financial accountability in nursing care.
• The software empowers nursing stations to analyze profitability and make informed decisions regarding resource management.