Classification / Acuity System for Med Surg patient

  1. Looking for some help...

    As I've noted before, we are a Med surg unit, one floor hospital so we operate really as a PCU. Due to reconstruction of our nursing home, we've also got a few skilled patients, and of course admin ( and by that, I mean HR specifically, don't ask how they are involved with this!) are screaming about us being over staffed. I've NEVER been given a HPPD #, only a FTE # which I've exceeded maybe 2 in 3 years.

    I am desperately searching for recent patient classifcation systems to utilze as we all know it's acuity, not #'s. It is nothing for us to have 4 in the am, 2 that noc, 6 the next am, and the day after that 14...with admits/discharges/transfers/ outpatient get the picture.

    If anyone can help I am so grateful ahead of time!!!!!

    Thank you!
  2. Visit Luv Nursing profile page

    About Luv Nursing

    Joined: Mar '08; Posts: 19; Likes: 7


  3. by   HouTx
    Wow - some challenge.

    Unfortunately, most of the 'acuity systems' are based on proprietary information, so users cannot share any information. Short term, I would recommend that you get your hands on ChrysMarie Suby's annual survey of nursing hours. You can order it through her website She also publishes quarterly newsletters.

    Chrys conducts annual (voluntary) surveys of nurse staffing - her annual reports are widely used as benchmarks. She also has quantified what she calls "ATD' (admission, transfer, discharge) workload that adds a lot to any department, but is seldom captured in any staffing system.

    Unless you organization is commited to purchasing an acuity system, you may have to just go with a reasonable benchmark and begin to carefully -track your case mix index. (Even the bean counters understand CMI) Then you can tie your HPPD to your CMI.

    I would also advise you to think about allocating resources based on 2 dimensions...
    1. workload: the amount of physical labor involved in patient care
    2. Intensity: the type of work that only RN/licensed can do - closely tied to CMI
    You will likely find that your SNF-type patients require more 'work', but it can be accomplished by NAs rather than nurses.

    Good Luck!