A computer simulation program to facilitate budgeting and staffing decisions in an intensive care unit

ICUs have unique problems in choosing their best staffing levels for direct patient care because each unit's total patient needs per shift, quantitated in acuity points, vary widely. We devised a computer program to simulate our 12-bed medical/cardiac ICU workload and staffing system. Nursing staffing policies, costs, and availabilities, and a table of past patient acuities per shift were input; total overstaffing, understaffing, and cost per year for full-time nursing equivalents (FTEs) for direct patient care were output for different staffing levels. Using the model, we considered financial concerns, quality of care issues, and staff working preferences and determined that our best staffing level would be based on 5.5 direct FTEs per shift. The stimulation analysis is straightforward, flexible, adaptable, and easy to update and use.