Staffing Ratio

Capacity management systems create insight into required resources like staff and equipment. For inpatient hospital care, capacity management requires information on beds and nursing staff capacity, on a daily as well as annual basis. This paper presents a comprehensive capacity model that gives insight into required nursing staff capacity and opportunities to improve capacity utilization on a ward level. [from abstract]

This study explored nurse staffing decision-making processes, supports in place for nurses, nursing workload being experienced, and perceptions of nursing care and outcomes in Canada. A number of key themes emerged from the study that can form the basis for policy and practice changes related to determining appropriate workload for nursing in Canada. These include the use of staffing principles and frameworks, nursing workload measurement systems, nurse-to-patient ratios, and the need for uptake of evidence related to nurse staffing. [adapted from abstract]

The difficulty of ensuring an adequate and appropriate distribution of health services, together with increasing financial pressures in the public sector, are forcing many countries to consider using more rigorous methods for determining staffing levels in the health facilities. The Workload Indicators of Staffing Need (WISN) method is one such method. It uses a form of activity analysis (activity standards), together with measures of utilisation and workload to determine staffing requirements. The method provides a vehicle for assessing localised staffing needs that is believable and which at the same time is sharply different to historic methods.

Uganda Catholic Medical Bureau (UCMB) affiliated hospitals, like many other health institutions, are stressed by limited resources and increasing costs. This calls for a need to finance the increasing costs through efficiency gains on fixed inputs. Determining optimal staffing levels and skill mix would ensure efficiency gains on personnel whose costs account for 31-65% of UCMB’s total recurrent expenditure. It would also match the staffing to the workload. A descriptive cross sectional study was carried out in four UCMB hospitals with the main objective of setting standard workloads for each staff category.

The 2004 Egypt Service Provision Assessment (ESPA 2004) survey was designed to collect informationon the provision of reproductive health and child health services in Egypt in order to complement the information obtained through the 2003 Egypt Interim Demographic and Health Survey. The ESPA 2004 collected information on the preparedness of health facilities in Egypt to provide high quality care to clients seeking services for family planning, maternal health, child health, and sexually transmitted infections. A representative sample of 659 clinics of all types of facilities, in both government and nongovernmental organization facilities, was assessed. The survey included, in addition to the resources of the facilities, interviews with service providers, observations of consultations between the providers and clients, and interviews with clients after they were served. The information included in this report is important for identifying areas of intervention that will help improve the quality of family planning, maternal health, and child health services provided to clients. [preface]

Efforts to increase access to life-saving treatment, including antiretroviral therapy (ART), for people living with HIV/AIDS in resource-limited settings has been the growing focus of international efforts. One of the greatest challenges to scaling up will be the limited supply of adequately trained human resources for health, including doctors, nurses, pharmacists and other skilled providers.

This study was a synthesis of the best available evidence and provision of policy recommendations in the area of nurse staffing and patient safety.
The results of the synthesis indicate a significant relationship between nurse staffing and patient safety. Evidence also shows there are moderating factors, such as nurse characteristics and organizational factors, which influence the relationship between nurse staffing and patient safety. The findings also demonstrate the importance of linking the implementation of good nurse staffing initiatives with effective leadership and management concepts.

Policy makers and hospital administrators are seeking evidence to support nursing staffing decisions that includes both the volume and mix of nurses required to provide efficient and effective care. The principal objective of this study was to examine the interrelationships between variables thought to influence patient, nurse, and system outcomes. The results provide quality, evidence-based standards for adjusted ranges of nursing productivity/utilization and for staffing levels for patients receiving cardiac and cardiovascular nursing care. [from executive summary]

This report presents results from the Egypt Health Care Providers Surveys, the objectives of which were to: provide a comprehensive picture of all sources of health care services; provide policy relevant data on critical issues for health sector reform; and create a database on health care providers for use by the Ministry of Health and Population in developing policy reform proposals. Five separate surveys were conducted on health care institutions, private clinics, pharmacies, dayas (traditional birth attendants), and other practitioners. The sample of 10,048 providers was developed from a complete enumeration of all health care providers in sampling areas and data from the 1986 national census.

This analytical report is conducted to measure the gap between the available staffing resources of health services in greater Darfur and the identified minimum standards to be attained in disaster assistance. Key indicators of staffing levels (i.e. home visitors, doctors, health workers, ORT, etc) are used to measure these standards. Different levels of PHC system (i.e., community level, peripheral health facility, central health facility, and referral hospital level) are presented to show the coverage of the medical staffing resources per states on locality levels. [author’s description]

These documents aim for a level of staffing and skill mix that is determined by patient need and level of dependency to ensure that patients’ needs are met. Therefore, effective workforce planning is essential. This guidance looks at the considerations for employers, senior nurses and others planning staffing needs at ward, unit and organisational level. [from introduction]

This report summarizes the findings of AHRQ-funded and other research on the relationship of nurse staffing levels to adverse patient outcomes. This valuable information can be used by decisionmakers to make more informed choices in terms of adjusting nurse staffing levels and increasing nurse recruitment while optimizing quality of care and improving nurse satisfaction. [author’s description]

Twelve percent of the adult population in Malawi is estimated to be HIV infected and 15% to 20% of these are in need of life saving antiretroviral therapy. Using data on the total number of patients on highly active antiretroviral treatment (HAART) and estimates of the number of health professionals required to deliver HAART, researchers set out to determine the human resources requirements for HAART scale-up in Malawi. Results show that the human resources requirements are significant and that Malawi is using far fewer human resources than would be expected based on past studies. [adapted

The purpose and objectives of this study are to examine the extent to which the manager’s span of control influences nurse, patient, and unit outcomes; and investigate which particular leadership style contributes to optimum nurse, patient, and unit outcomes under differing spans of control. [author’s description]

This study demonstrates how Workload Indicators of Staffing Need (WISN) can be used as a human resources planning and management tool for improving decisions at all levels of health services about the provision, allocation and deployment of staff. [from abstract]

Imbalance in the cadre mix, number, distribution, and quality of health personnel are major concerns for health planners and policy makers. Many methods were developed and used to project future supply and requirement for health personnel. This paper modified the population-to-physician ratio method, by taking into account the specific characteristics of the Thai health care system, and of the future economic scenarios to project requirements of Thai physicians over the next twenty-five years. [from abstract]

This review was designed to assess how nurse to patient ratios and nurse work hours were associated with patient outcomes in acute care hospitals, factors that influence nurse staffing policies, and nurse staffing strategies that improved patient outcomes. [from abstract]

Despite growing evidence in the US, little evidence has been available to evaluate whether internationally, hospitals in which nurses care for fewer patients have better outcomes in terms of patient survival and nurse retention. The objectives of this article are to examine the effects of hospital-wide nurse staffing levels (patient-to-nurse ratios) on patient mortality, failure to rescue (mortality risk for patients with complicated stays) and nurse job dissatisfaction, burnout and nurserated quality of care. [from abstract]

The Swiss government decided to freeze new accreditations for physicians in private practice in Switzerland based on the assumption that demand-induced health care spending may be cut by limiting care offers. This legislation initiated an ongoing controversial public debate in Switzerland. The aim of this study is therefore the determination of socio-demographic and health system-related factors of per capita consultation rates with primary care physicians in the multicultural population of Switzerland. [from abstract]

This report examines the workforce issues surrounding HIV/AIDS service delivery. At the request of the Government of Rwanda, data were collected on current health sector staffing and from 20 public and private facilities of various sizes and characteristics on the time required to provide HIV/AIDS services and the quality of those services. The report presents data relative to the numbers of clients needing different types of HIV/AIDS services, providers’ degree of compliance with service delivery standards, and the time it takes to provide services. Staffing scenarios are projected to estimate how many staff would be required to meet targets, and from them, costs are projected.

This presentation was part of the AIDS Law Project’s Human Resources for Health seminar, which was held to address the challenges facing the health sector. The presentation discusses the nursing shortage and the factors that contribute to this problem including poor working conditions, work overloads, the effect of HIV and out-migration. It makes the case that training new nurses alone will not solve the problem, that the high-level of nurse burnout is an indicator that the conditions of the job must be improved before adequate numbers of nursing staff can be retained.

To view this presentation, you must have either Microsoft PowerPoint or download the free PowerPoint Viewer.

One of the resolutions at the RCN’s 2000 Congress expressed concerned at the lack of a universal mechanism to determine safe staffing levels. This reflected widespread concern within the profession about the potential increase in risks to patient safety posed by increased levels of activity, and inadequate levels of nurse staffing, in the NHS. Over the years, there have been many attempts to develop a universally acceptable and reliable formula which will be able to predict the precise nurse staffing levels needed to ensure patient safety. Even if this is not a realistic goal, and the literature on workforce planning suggests that it is not, the Congress resolution provided a timely opportunity to reconsider the important professional and managerial issues associated with setting safe staffing levels.

The Workload Indicators for Staffing Levels was created to provide a rational method of setting the correct staffing levels in health facilities, taking into account the the wide local variations which are found within every country, such as the different levels and patterns of morbidity in different locations, the ease of access to different facilities, the patient attitudes in different parts of the country to the services provided, and the local economic circumstances. This Manual sets out all the activities which are necessary in order to design and implement the WISN Method in a country.