Getting It Right for Our Patients

Data-informed tool helps hospitals appropriately staff in the moment and in the future

Guest bloggers Patricia Dilley, Director of Clinical Information Systems for AcuityPlus, a division of Harris OnPoint, and Deann Shaver, Principal Consultant for the AcuityPlus product, take a look at New York’s recently enacted clinical staffing committee law and what it will mean for hospitals and patients.  Patient safety and flexible staffing are at the heart of the legislation, as is an acknowledgement that variations in case severity are in constant change, requiring a health outcomes and data-informed approach to staffing. This has never been truer than during the past 20 months, when hospital staffing was stretched to the max by the demands of the pandemic.

New York’s hospitals are prepping for the implementation of the state’s clinical staffing committee law, which takes effect January 1, 2022.  That’s when each hospital officially begins working on forming a multidisciplinary committee and subsequent staffing plan – the annual document that will serve as a multidisciplinary staffing blueprint for each facility.  The legislation was signed into law this past spring by former Governor Cuomo.  Importantly for hospitals, it recognizes that a one-size fits all staffing plan is not the best approach for patients.  Patient mix related to severity of illness, co-morbid conditions, and uncontrollable fluctuations in patient volume all affect the appropriate staffing levels at hospitals.

The devil is in the details and that’s always the case with nursing duties and patient needs on different hospital units.  Nursing workloads are as varied and diverse as the patients in a hospital, which is why Harris OnPoint realized back in 1975 that a more real-time solution to staffing was needed.  We also knew that it had to be nurse driven, based on research and science, and maintained by clinical nursing staff. 

When you look at the nursing process, you realize that there are an infinitesimal list of tasks and skills that are in play – some of the time, part of the time, or maybe even all of the time.  Tasks such as assessment, intervention, planning for care, and even time spent talking with and caring for patient’s family members happen around-the-clock.  Prescriptive patient-staff ratios, such as those enacted in California, attempt to uniformly quantify staff needs, but the approach ignores one major component of the nursing process – all patients are different, all cases are different.  Research shows that mandated ratios are not necessarily the answer, which brings us back to the patient diversity and workload diversity reality. 

As nurses, we knew there had to be a better solution.  Data-driven, semi-artificial intelligence platforms have grown out of a desire to more accurately pinpoint unit activity and needs and, more importantly, to predict what clinical staff will be needed where and when.  The AcuityPlus tool is one product that is taking the guesswork out of staff planning for hospitals.  AcuityPlus users have the flexibility to look at patient workload and adjust staffing accordingly as patient care and nursing workload changes (for example, pre-shift, during shift and for the forecasted future). In the end, this improves patient care and outcomes and improves the hospital’s bottom line.  One AcuityPlus user reduced overtime by $230,000 because the tool allowed the hospital to better allocate their staff, relying less on traveling nurses and overtime.  This is one way to counteract the exorbitant and unexpected labor costs brought on by the pandemic.

Kathy Matson, the nursing administrator of nursing resources for Mayo Clinic Arizona says “AcuityPlus builds a bridge between nursing and finance, enabling the 24 x7 world of nursing to be understood by the 8 x 5-hour finance team.” 

But a nursing-focused, patient-centered staffing solution offers way more than just savings to the hospital.  Clinical nursing staff are involved in the selection of   unit parameters that will be used in the platform’s algorithm, which empowers and recognizes their clinical skills and decision-making abilities.  This leads to more satisfied nurses, more satisfied patients, and ultimately, a competitive edge for the hospital in this tough workforce environment. (One survey found that the average cost of turnover for a bedside RN is $40,038.)  The tool also produces a data book, allowing the hospital to benchmark how its staffing data aligns with other hospitals in its market, regionally, and even nationally.

New York’s clinical staffing committee law will put pressure on hospitals to really get their staffing plans right.  Those hospital committees that include highly-skilled nurses that understand the staffing process and its challenges, are well-respected by their peers, and have buy-in from leadership will easily develop plans that include built-in flexibility and are designed for the way each unit operates.

About the Suburban Hospital Alliance of New York State

The Suburban Hospital Alliance of New York State advocates on behalf of hospitals in the Hudson Valley and Long Island regions. It engages key lawmakers and regulatory decision-makers in Albany and Washington to ensure reasonable and rational health care policy prevails.

About the Nassau-Suffolk Hospital Council (NSHC)   

The Nassau-Suffolk Hospital Council represents the not-for-profit and public hospitals on Long Island. It works in conjunction with the Suburban Hospital Alliance of New York State to advance legislative and regulatory priorities.  NSHC serves as the local and collective voice of hospitals on Long Island.

About the Northern Metropolitan Hospital Association (NorMet)  

The Northern Metropolitan Hospital Association represents the not-for-profit and public hospitals in the Hudson Valley region. It works in conjunction with the Suburban Hospital Alliance of New York State to advance legislative and regulatory priorities.  NorMet serves as the local and collective voice of hospitals in the Hudson Valley.

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