Classification / Acuity System for Med Surg patient

[Luv Nursing]

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 procedures....you get the picture.

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

Thank you!

[HouTx, BSN, MSN, EdD]

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 http://71.39.108.170/LMI/ 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!