Acuity-Based Staffing in Labor and Delivery Using Electronic Health Record Data

Area of Science:

• Nursing Administration
• Health Informatics
• Quality Improvement

Background:

• Nurse staffing in labor and delivery is complex due to unpredictable patient census and acuity.
• Electronic health records (EHR) offer valuable patient data for analyzing staffing needs and gaps.
• Retrospective analysis of EHR data can inform prospective nurse staffing plans.

Purpose of the Study:

• To develop real-time and longitudinal reports using EHR data to quantify hourly nurse staffing requirements.
• To analyze patient census, acuity, and clinical interventions to determine staffing needs.
• To identify staffing trends and patterns aligned with Association of Women's Health, Obstetric, and Neonatal Nurses (AWHONN) guidelines.

Main Methods:

• Collaboration between obstetric nursing leadership and information technology specialists.
• Development of an algorithm within the EHR to assess patient acuity and required interventions.
• Creation of EHR-based reports for real-time and historical nurse staffing insights.

Main Results:

• Quantitative data from reports supported increased nurse staffing budgets.
• Implementation of a more flexible nurse staffing scheduling system.
• Successful project rollout across all four hospital system maternity units.

Conclusions:

• Integrating nurse staffing data into EHR systems is feasible and beneficial.
• EHR data integration enables real-time alignment with AWHONN staffing standards.
• Leveraging historical EHR data aids in projecting future nurse staffing needs.