An Innovative Staffing Resource for Unpredictable Census and Acuity Fluctuations in Critical Care

2.50
Hdl Handle:
http://hdl.handle.net/10755/157088
Category:
Abstract
Type:
Presentation
Title:
An Innovative Staffing Resource for Unpredictable Census and Acuity Fluctuations in Critical Care
Author(s):
Davenport, Karyl; Quin, Matthew; Fortino, Margaret M.; Thomas-Browning, Joyce; Eagan-Bengston, Elizabeth; Golden, Shaun; Morgan, Macgregor; Reilly, Karen; Leone, Kathleen; Rumble, Catherine; Buchanan, Teresa; Precourt, Justin
Author Details:
Karyl Davenport, Brigham and Women's Hospital, Boston, Massachusetts, USA, email: kdavenport@partners.org; Matthew Quin; Margaret M Fortino; Joyce Thomas-Browning; Elizabeth Eagan-Bengston; Shaun Golden; Macgregor Morgan; Karen Reilly; Kathleen Leone; Catherine Rumble; Teresa Buchanan; Justin Precourt
Abstract:
PURPOSE: Ten Critical Care Nurse Managers in an academic medical center identified the need to manage staffing in a proactive, innovative and fiscally responsible way by coming together as a critical care group. The goal was to manage staffing based on volume and acuity rather than staffing to a set number of beds. Challenges to this included matching caregiver skills with patient needs, expediting patient flow among Hospital units, creating staffing contingencies for unplanned ICU admissions. Description: Historical data analysis revealed patterns and trends in acuity, census, and Emergency Department ICU admission history for each unit. Collaborative programmatic planning with physician and administrative leaders provided volume projections and changes in patient populations that would impact staffing. As this project was underway ICU volume significantly decreased complicating the challenges already identified. As staffing was adjusted to volume and acuity, need for a registered nurse to support unplanned ICU admissions was identified. A Designated ICU Nurse (DIN) role was created in June 2007. This nurse is immediately available 24/7 and deployed by a Nurse Administrator for an unplanned admission or acuity change. The DIN provides a bridge for care and staffing for a four hour period of time while unit based ICU staffing is evaluated/adjusted. DIN use was monitored over time, and within two months a second DIN was added during times of high utilization. Contingency plans were created whenever the DIN was assigned in case another unplanned need arose. The credibility and success of this approach in staffing to volume and acuity was dependent on good communication, close monitoring and re-evaluation of this resource. EVALUATION: The DIN role has been a very effective tool in meeting the ICU staffing needs for unplanned admissions and changes in acuity. DIN utilization has been carefully tracked, and periodic evaluations are conducted regarding use. Times of peak deployment by day, time, reason and area have been identified and the plan adjusted accordingly. Staffing to volume and acuity, supported by the DIN role has been achieved greater than 90% of the time. It also has had a positive impact on adherence to budget while maintaining the quality of care provided to patients and families.
Repository Posting Date:
26-Oct-2011
Date of Publication:
26-Oct-2011
Citation:
2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.
Conference Date:
2009
Conference Name:
National Teaching Institute and Critical Care Exposition
Conference Host:
American Association of Critical-Care Nurses
Conference Location:
New Orleans, Louisiana, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleAn Innovative Staffing Resource for Unpredictable Census and Acuity Fluctuations in Critical Careen_GB
dc.contributor.authorDavenport, Karylen_GB
dc.contributor.authorQuin, Matthewen_GB
dc.contributor.authorFortino, Margaret M.en_GB
dc.contributor.authorThomas-Browning, Joyceen_GB
dc.contributor.authorEagan-Bengston, Elizabethen_GB
dc.contributor.authorGolden, Shaunen_GB
dc.contributor.authorMorgan, Macgregoren_GB
dc.contributor.authorReilly, Karenen_GB
dc.contributor.authorLeone, Kathleenen_GB
dc.contributor.authorRumble, Catherineen_GB
dc.contributor.authorBuchanan, Teresaen_GB
dc.contributor.authorPrecourt, Justinen_GB
dc.author.detailsKaryl Davenport, Brigham and Women's Hospital, Boston, Massachusetts, USA, email: kdavenport@partners.org; Matthew Quin; Margaret M Fortino; Joyce Thomas-Browning; Elizabeth Eagan-Bengston; Shaun Golden; Macgregor Morgan; Karen Reilly; Kathleen Leone; Catherine Rumble; Teresa Buchanan; Justin Precourten_GB
dc.identifier.urihttp://hdl.handle.net/10755/157088-
dc.description.abstractPURPOSE: Ten Critical Care Nurse Managers in an academic medical center identified the need to manage staffing in a proactive, innovative and fiscally responsible way by coming together as a critical care group. The goal was to manage staffing based on volume and acuity rather than staffing to a set number of beds. Challenges to this included matching caregiver skills with patient needs, expediting patient flow among Hospital units, creating staffing contingencies for unplanned ICU admissions. Description: Historical data analysis revealed patterns and trends in acuity, census, and Emergency Department ICU admission history for each unit. Collaborative programmatic planning with physician and administrative leaders provided volume projections and changes in patient populations that would impact staffing. As this project was underway ICU volume significantly decreased complicating the challenges already identified. As staffing was adjusted to volume and acuity, need for a registered nurse to support unplanned ICU admissions was identified. A Designated ICU Nurse (DIN) role was created in June 2007. This nurse is immediately available 24/7 and deployed by a Nurse Administrator for an unplanned admission or acuity change. The DIN provides a bridge for care and staffing for a four hour period of time while unit based ICU staffing is evaluated/adjusted. DIN use was monitored over time, and within two months a second DIN was added during times of high utilization. Contingency plans were created whenever the DIN was assigned in case another unplanned need arose. The credibility and success of this approach in staffing to volume and acuity was dependent on good communication, close monitoring and re-evaluation of this resource. EVALUATION: The DIN role has been a very effective tool in meeting the ICU staffing needs for unplanned admissions and changes in acuity. DIN utilization has been carefully tracked, and periodic evaluations are conducted regarding use. Times of peak deployment by day, time, reason and area have been identified and the plan adjusted accordingly. Staffing to volume and acuity, supported by the DIN role has been achieved greater than 90% of the time. It also has had a positive impact on adherence to budget while maintaining the quality of care provided to patients and families.en_GB
dc.date.available2011-10-26T19:24:39Z-
dc.date.issued2011-10-26en_GB
dc.date.accessioned2011-10-26T19:24:39Z-
dc.identifier.citation2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.en_GB
dc.conference.date2009en_GB
dc.conference.nameNational Teaching Institute and Critical Care Expositionen_GB
dc.conference.hostAmerican Association of Critical-Care Nursesen_GB
dc.conference.locationNew Orleans, Louisiana, USAen_GB
dc.identifier.citation2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.en_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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