Best Practice Staffing Provides Timely and Effective Patient Care, While Providing a Safe

Chapter 15

Effective Staffing

Best practice staffing provides timely and effective patient care, while providing a safe environment for patients and staff,and promoting a culture of professionalism.

The delivery of safe and effective nursing care depends on several factors such as the experience and knowledge of nursing staff, the severity of patient acuity, and the skill mix of the nursing staff.Other contributing factors to safe staffing include the application of a patient care delivery model and organizational contribution to quality health care.This chapter focuses on several issues such as ensuring adequate staffing, adjusting work intensity based on patient volume, and applying various care models to meet patients’ needs.

Several key terms are emphasized throughout the text such as full-time equivalent (FTE), productive versus nonproductive hours, direct versus indirect care, and nursing hours per patient day (NHPPD).

Patient classification systems (PCS) are measurable tools used to project and describe nursing workload for both a specific population of patients and patients on a case by case basis.These systems are crucial when determining the amount of nursing care required to meet staffing guidelines, benchmarking among peers, and benchmarking during the budgeting process.Staffing plans include a matrix to determine the type of nursing skill mix, experience, and volume that is necessary to achieve optimal outcomes.The staffing plans are created through several influences:benchmark results, best practice and standards of care, as well as regulatory demands such as the State Nurse Practice Act and JCAHO standards and patient acuity.

Continual assessment and evaluation are necessary to determine the effectiveness and feasibility of an implemented staffing plan.Those with a vested interest must focus on several revealing factors such as patient outcomes and patient and staff satisfaction.Leaders must also create innovative means to meet the scheduling and staffing needs of all their customers, including patients and nurses.Flexible scheduling, weekend plans, and self-scheduling are a few common practices in the scheduling process.

Organizations can adopt a variety of patient care models for care delivery.A few of the more common models include case management, primary care, modified primary, team nursing, and patient-centered care.Various care delivery management tools are utilized to decrease cost and length of stay while consequently increasing the quality of patient care.