Measuring acuity

kadokin, ASN, RN · May 20, 2005

Hi there I work in adult community mental health, (10 years post grad, NZ) lately we have been losing staff by the truck load, due to a number of issues, mainly high caseloads, lack of staff poor Dr cover etc
I was asked to find a tool to measure the acuity of a patient,eg how much work one pt was compared to another
I dont feel this is the sum total of the problem , however we have a culture of measuring stress by how big your caseload is, so Im trying to prove a caseload of 3 difficult pts is the same as a caseload 30 easy pts
hope this makes some sense
Funny Im also a bit stressed!!

At the inpatient unit where I work we used to have a tool for measuring acuity that was developed by a company named Ernst&Young. I don't know if they are still in this business, maybe an internet search for their name might help. Good luck!

lrae · May 20, 2005

At the inpatient unit where I work we used to have a tool for measuring acuity that was developed by a company named Ernst&Young. I don't know if they are still in this business, maybe an internet search for their name might help. Good luck!

Thanks for that I will see what I can find

CharlieRN · May 20, 2005

We use a variety of measures. One is the LOCUS seven point system for measuring patient acuity. That is primerily related to identifying and quantifying the patient's need for inpatient care. Also we periodicly do time use studies. We are asked th make a log of how our day is spent in 5 min blocks. Staff absolutly hate this of course but maybe some useful info is developed..

lrae · May 21, 2005

We use a variety of measures. One is the LOCUS seven point system for measuring patient acuity. That is primerily related to identifying and quantifying the patient's need for inpatient care. Also we periodicly do time use studies. We are asked th make a log of how our day is spent in 5 min blocks. Staff absolutly hate this of course but maybe some useful info is developed..

Thanks for that will have a look and see what I can find re this (as long as my PC dosent crash again, due to myself mucking around with the registry!!)

We have done a number of time and motion studies (werent called this of course!) an interesting outcome was we didnt have the time to complete these acurately (especailly our crisis team) however less busy centres did, the results showed we we not as busy as the other centres, resulting in funding being reduced to us and boosted to quieter centres, an inherant flaw, from what I can see!!

Interested Party · May 21, 2005

Have you tried contacting other mental health services? I know that retention is a problem all over, due to the same reasons which you mentioned.

Blessings

IP:)

Mr Ian · Jan 23, 2009

I'm in Comm Mental Health too in Oz and have been considering this for myself. I've not researched it but my instinct tells me that due to the variant qualitative nature of CMH work it is almost impossible to create a reliable quantitative measure.

My leaning is towards a simplified model of 1 - 5 'types' of pts that present with a cluster of needs assigned to each category. Once their needs exceed the cluster into the next group they are incremented an acuity rating.

eg:

contact: daily ; twice weekly ; weekly ; two weekly; monthly

intensity/intolerance of symptoms: high ; moderate ; low

functional impact: high ; moderate ; low

etc.

Perhaps a GAF scoring model would help? - as most interventions are a response to needs that are identifiable in the GAF.

Whispera, MSN, RN · Jan 24, 2009

Hospitals have acuity rating scales. I've filled them out on each patient. Where I used to work we were supposed to complete them each day but people didn't do it regularly so they drifted off into the sunset. You could try called people in charge of area facilities to see what they have.