A Methodology for Nurse Staffing

by Bruce Meglino



This article describes a protocol aimed at more efficient use of nursing personnel and a method for a more accurate determination of patient load. Much of the inefficiency involved in the allocation of personnel stems from the fact that hospitals make a number of common errors with regard to staffing. The first error occurs at the time forecasts are prepared. Forecasts are frequently prepared for the long term and thus, hospitals are unable to detect and respond to short term fluctuations. As a result, actual occupancy may run well below forecast for several months without adjustments being made in such situations, individuals are added to the staff in anticipation of an increase in patient load. Patient load, however, does not automatically increase at the time budgets are approved rather, it increases gradually over the budget period. This results in overstaffing. Another problem occurs when in some instances the level of aggregation of forecast is too great for it to be particularly useful. A forecast of the overall utilization rate is often made for the entire hospital. In this case, while the overall forecast may indicate that patient load is increasing, some of this increase may occur within units that can easily absorb additional loads with existing personnel.

California Management Review

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