Using Technology to Achieve Clinically-Driven Staffing Effectiveness

Transcription

1 Background sought a technology that would support the use of nurse documentation to drive acuity values and staffing decisions. 1. Many acuity systems are labor intensive for bedside nurses. 2. User-friendly acuity systems lack the objectivity and reliability needed to make logical staffing decisions. The multiple steps and calculations needed for scientific Taylor based time methodology required extensive nursing time. Conversely, easily usable systems that require minimal nursing intervention lack the validity needed for budgeting or staffing. This work-driven acuity system, based on nursing documentation, provides both validity and usability it is transparent to nursing staff and useful for resource allocation. It s a smart approach that rewards timely documentation without burdening bedside caregivers. Jeff Pike, Associate Vice President

2 Setting Akron, Ohio 511-bed hospital 1,000 physicians 3,400 employees Level One Trauma Center Level One Labor and Delivery 23 Nursing Units Critical Issues Lack of an objective, easy-to-use acuity management system Lack of acuity-driven staffing Lack of transparency into nurse productivity

3 Solution Akron General partnered with McKesson on a workload-driven acuity system, ANSOS One-Staff Assignment and Workload Manager with Acuity Aggregator. The system: Uses a real-time feed of electronic documentation to aggregate criteria into patient-level assignments Captures acuity data, including patient outliers and workload exceptions Requires no extra work from caregivers Captures ADT data from Akron s HIS vendor in a continuous, real-time HL7 feed Overall, the solution gives me a clear picture of the patient activity on my unit, and helps me prepare for staffing each shift. Joyce Moore, MSN, RN, NE-BC Director Nursing/Patient Services

4 Method How does the new system work? 1. Nurses document care efficiently and accurately. 2. Acuity Aggregator produces accurate, objective acuity scores, based on electronic nurse documentation. 3. Acuity Aggregator uses a logical model of time allocation by activity to determine real-time ANSOS One-Staff TM staffing recommendations. 4. Nurse managers and the staffing office use acuity data to develop equitable staffing assignments based on ANA standards. 5. Nurse managers can access the web-based system remotely, monitoring their units from any location including home. The Acuity Aggregator has moved staffing to a more patient-focused experience. We are reaching productivity goals while ensuring our staffing mix is tailored to fit the needs of the patient population. Kristen Speros, Staffing Office Manager

5 Results Enables nurse managers to staff nursing units based on an accurate assessment of patient acuity Supports the creation of equitable staffing assignments forecasted for the next 24 hours Improves nursing productivity by eliminating 20 minutes of acuity assessment time on each shift for each nurse Ensures each patient receives the appropriate level of care Improves the quality of patient care through effective staffing ratios Rewards nurses for accurate, timely documentation and eliminates the task of acuity scoring and calculation Acuity Aggregator is the missing link. I can pull up the house-wide/unit census in the HIS and the staff list in ANSOS One-Staff, but the real information about the types of patients and the flow of ADT is found here. This is real-time information I can trust, because it comes from the bedside nurse. On the weekends, I can see from home what s going on in my unit. Beth Srock, Clinical Manager, CCU/PCU

6 Return on Investment (ROI) Akron General has two 12-hour shifts. House-wide, we have 23 Nursing units. On average, 162 nurses work day shift, and 142 nurses work night shift. The Acuity Aggregator saves each nurse an average of 20 minutes per shift.

7 Our overall time savings can be calculated as follows: 162 Nurses x 20 minutes = 3,240 minutes/60 minutes = 54 hours x 365 days = 19,710 hours 142 Nurses x 20 minutes = 2,840 minutes/60 minutes = 47 hours x 365 days = 17,155 hours Every day, Akron General is saving 101 hours of nursing time, which equates to 36,865 hours a year which is a savings of 17.7 FTEs a year! (Note: one FTE = 2,080 hours/year.) The time savings provided by the Acuity Aggregator is helping Akron General bring staffing back to the bedside, keeping the focus right where it belongs: on caring for our patients.