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Harnessing ward-level administrative data and expert knowledge to improve staffing decisions: A multi-method case
Christine Duffield1,2, Michael A Roche1, Sarah Wise3
1Centre for Health Services Management, Faculty of Health, University of Technology Sydney, Ultimo, Australia.
Journal of Advanced Nursing
|October 1, 2019
Summary
Changes to hospital bed configuration and patient mix increased nurses' workload due to more complex patients and reliance on temporary staff. Existing data and nursing unit manager expertise can optimize staffing and bed management.
Area of Science:
- Healthcare Management
- Nursing Workload Analysis
- Hospital Operations
Background:
- Effective nurse staffing and bed management are critical for patient care quality and safety.
- Ward configuration and patient mix significantly influence nursing workload.
- Optimizing hospital resources requires understanding the interplay between operational changes and staff demands.
Purpose of the Study:
- To investigate the impact of bed configuration and patient mix changes on nurses' workload in a hospital ward.
- To identify factors contributing to increased workload following operational adjustments.
- To explore potential solutions for improving staffing and bed management decisions.
Main Methods:
- A multi-method case study was conducted in a 28-bed acute care ward.
- Administrative data (patient activity, nurse staffing) were collected for 12 months before and after bed configuration changes.
- Semi-structured interviews were performed with 17 ward nurses to gather qualitative insights.
Main Results:
- Bed configuration changes led to increased patient complexity, dependency, and transfer activity.
- Nurses reported intensified workloads due to patient changes and increased reliance on temporary nursing staff.
- Staffing decisions, including skillmix and temporary personnel, further exacerbated workload challenges.
Conclusions:
- Hospitals can leverage existing data and nursing unit manager expertise for improved staffing and bed management.
- Addressing patient complexity, dependency, and churn is essential for managing nurse workload.
- Empowering nursing unit managers with data and decision-making authority can enhance efficiency, safety, and patient care quality.
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