Effects of Staffing Matrix on Clinical outcomes

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Effects of Staffing Matrix on Clinical outcomes

• Karen Loden, MN, RNDr. Linda Corson Jones
  Memorial Research DayApril 11, 2008

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Learner Objective

• Discuss the relationship of the current staffing
  matrix to clinical patient outcomes

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Staffing Matrix

• Definition a mathematical model that shows the
  number of patients and required staff by skill
  level for a 24 hour period

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Development

• Staffing matrix developed
• To achieve appropriate skill mix on in patient
  care units
• To achieve realistic and reliable staffing within
  budget parameters and professional standards

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Staffing Matrix Sample
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Application in clinical area

• Does not supersede professional judgment in
  staffing
• Matrix facilitates staffing decisions 3 times
  daily based on available staff, patient acuity
  and activity and census.

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Research Question asked

• Is there a relationship between the staffing
  matrix to patient outcomes of
• Length of stay
• Falls
• Medication Errors
• MET calls
• Code Blue
• Patient satisfaction (pain control, loyalty,
  personal needs, care and concern.

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Data Collection sources

• Data was collected for a six month period (July
  2007- December 2007) from the staffing software,
  Performance Improvement, Patient Satisfaction
  questionnaires and Financial services
• Used HPPD by skill level (hours worked not total
  hours) (hours per patient day hours worked by
  skill level/patient days or census for time
  period)

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Relationship of clinical outcomes

• There was no relationship between the variables
  of LOS, MET calls, and Code Blue and the HPPD.
• There was not a statistical difference when
  comparing the matrix HPPD and the actual HPPD.
• There was an inverse relationship between RN HPPD
  and falls, and medication errors, but it was not
  statistically significant.
• There is a relationship between the RN, LPN and
  UAP HPPD to patient outcomes of pain control,
  loyalty, personal needs, care and concern.

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Correlation
r 0.55, this was put into the regression
model correlation is significant at the 0.01
level correlation is significant at the 0.05
level
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Regression Pain Perception
A great deal of effort has surrounded our
communication related to pain management which
may be why there is not predictive relationship.
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Regression Loyalty
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Regression Personal Needs
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Regression Care and Concern
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Implications for Nursing Administration

• The matrix offers a guide to help consistency in
  number of hours provided by skill level.
• Review and adjust matrix at regular intervals
  during fiscal year
• Skill mix needs to be evaluated when staffing, to
  achieve positive patient outcomes.
• Value all skill levels in nursing to achieve
  positive patient outcomes.

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Recommendations

• Identification of how to utilize the staff we
  have on duty to meet patient needs
• Ask the nursing staff what works, then act on it.
• Provide adequate support for RNs.
• Investigate the LPN role in patient care and
  patient satisfaction.
• Develop scripting using solution starters.
• Continue data collection for next 6 months

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Questions

• kloden_at_ololrmc.com
• kloden_at_bellsouth.net