Acuity Staffing: A Five-Year Success Story in Staffing and Emergency Department

2.50
Hdl Handle:
http://hdl.handle.net/10755/162936
Type:
Presentation
Title:
Acuity Staffing: A Five-Year Success Story in Staffing and Emergency Department
Abstract:
Acuity Staffing: A Five-Year Success Story in Staffing and Emergency Department
Conference Sponsor:Emergency Nurses Association
Conference Year:2002
Author:Fullman, Charlene, RN, MA, CEN
P.I. Institution Name:Southside Hospital
Contact Address:3 Lyme Street, Wadiong River, NY, 11792, USA
Purpose: Staffing an emergency department with emergency nurses based on patient acuity is currently a regulatory necessity. Many standards have attempted to calculate RN staff by a volume ratio, but that does not account for huge variations in patient acuity and the RNs to provide that care. In adequate RN staff jeopardizes quality and ultimately decreases morale measured by an increased vacancy rate and low retention rate. It is pivotal for successful leaders to calculate staffing based on acuity. Design: Every patient is classified into an acuity category. Direct observation was used to tally direct and non-direct nursing care resulting in the average time to care for a patient of an assigned acuity. Setting: The formula is applied to 100% of patient volume. This is evaluated annually for budget reports and seasonally for managing volume fluctuations. It is also monitored hourly for adequate distribution of FTEs. Methodology: Total patient volume is divided and totaled by an acuity factor, such as Triage Level Codes, EM Levels, or Ambulatory Patient Classification (APC) codes. Each acuity level is assigned Emergency Nurse Hours (ENH) and multiplied to result in the Total Needed ENH. One Full-time Equivalent (FTE) Productive Hours are totaled based on the RN's yearly allotment of vacation time, personal time, break time, etc. Total ENH is divided by 1 FTE Productive Hours, resulting in the number of FTEs for the department to provide primary emergency nursing care. ENH considers all direct and non-direct care time for a particular patient. Efforts must be placed on calculating time to document, gather equipment, requisition specimens, consult with physicians, etc., in addition to the standard procedure times (i.e., insert a Foley, start an IV, etc.). Additions must be made for charge nurse and triage nurse assignments as these do not provide primary care. Results: Including the formula in a Staffing Proposal/Business Plan achieves approval from senior management and specifically Chief Finance Officers. The formula attains the necessary RN positions to meet emergency patient care needs. Conclusions: FTE vacancy and retention rates indirectly measure the formula's success. Our current vacancy rate is zero; and our retention rate over the past 12 months is 100%. [Clinical Poster Presentation]
Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleAcuity Staffing: A Five-Year Success Story in Staffing and Emergency Departmenten_GB
dc.identifier.urihttp://hdl.handle.net/10755/162936-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Acuity Staffing: A Five-Year Success Story in Staffing and Emergency Department</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2002</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Fullman, Charlene, RN, MA, CEN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Southside Hospital</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">3 Lyme Street, Wadiong River, NY, 11792, USA</td></tr><tr><td colspan="2" class="item-abstract">Purpose: Staffing an emergency department with emergency nurses based on patient acuity is currently a regulatory necessity. Many standards have attempted to calculate RN staff by a volume ratio, but that does not account for huge variations in patient acuity and the RNs to provide that care. In adequate RN staff jeopardizes quality and ultimately decreases morale measured by an increased vacancy rate and low retention rate. It is pivotal for successful leaders to calculate staffing based on acuity. Design: Every patient is classified into an acuity category. Direct observation was used to tally direct and non-direct nursing care resulting in the average time to care for a patient of an assigned acuity. Setting: The formula is applied to 100% of patient volume. This is evaluated annually for budget reports and seasonally for managing volume fluctuations. It is also monitored hourly for adequate distribution of FTEs. Methodology: Total patient volume is divided and totaled by an acuity factor, such as Triage Level Codes, EM Levels, or Ambulatory Patient Classification (APC) codes. Each acuity level is assigned Emergency Nurse Hours (ENH) and multiplied to result in the Total Needed ENH. One Full-time Equivalent (FTE) Productive Hours are totaled based on the RN's yearly allotment of vacation time, personal time, break time, etc. Total ENH is divided by 1 FTE Productive Hours, resulting in the number of FTEs for the department to provide primary emergency nursing care. ENH considers all direct and non-direct care time for a particular patient. Efforts must be placed on calculating time to document, gather equipment, requisition specimens, consult with physicians, etc., in addition to the standard procedure times (i.e., insert a Foley, start an IV, etc.). Additions must be made for charge nurse and triage nurse assignments as these do not provide primary care. Results: Including the formula in a Staffing Proposal/Business Plan achieves approval from senior management and specifically Chief Finance Officers. The formula attains the necessary RN positions to meet emergency patient care needs. Conclusions: FTE vacancy and retention rates indirectly measure the formula's success. Our current vacancy rate is zero; and our retention rate over the past 12 months is 100%. [Clinical Poster Presentation]</td></tr></table>en_GB
dc.date.available2011-10-27T10:36:42Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:36:42Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.