Hospital Staffing Planning, Training and Promotion

The Minnesota Hospital Association provides a workforce planning tool that helps hospitals develop a comprehensive plan. To begin workforce planning, hospitals must first define the plan, which includes mapping service changes, understanding the available workforce, and defining an action plan. This involves identifying the current skill mix of patient care personnel, including the average daily census, average length of stay, admission/discharge/transfer "churn factor," and number of procedures. Unit staffing is a key component of workforce planning, and it involves measuring the productivity of nursing departments. Units of service (UOS) are used to measure the product or service produced, and different units have different UOS measures. For example, inpatient units measure patient days, while outpatient units measure visits. Care delivery models are used to determine workload hours and staffing coverage. This involves projecting volume, determining workload hours, and allocating care hours per shift. The standard for direct nursing care is typically 8 hours per patient day, and the case mix acuity is used to determine the level of care required. Total paid nursing hours are calculated by adding productive hours, non-productive hours, and direct care hours. Productive hours include hours worked by nursing staff assigned to a unit who have direct patient care responsibilities for greater than 50% of their shift. Direct care hours include patient-centered nursing activities, such as medication administration, patient teaching, and coordination of patient care. Variable and fixed staff are used to categorize nursing staff based on their hours of work. Variable staff includes RNs, LPNs, and NAs, while fixed staff includes managers, HUCs, and unit-based educators. Full-time equivalents (FTEs) are used to calculate the equivalent of one full-time employee working for one year, and they are converted to positions that are filled by employees. The National Database of Nursing Quality Indicators (NDNQI) provides guidelines for data collection, including defining nursing hours, fixed hours, and full-time equivalents. By following these guidelines, hospitals can develop a comprehensive workforce plan that meets the needs of patients and ensures high-quality care.