Nursing Acuity

What is "acuity creep" ?

I have come to hate the word "acuity". I encountered it as a term used in running computer simulations of staffing requirements in a privately-owned hospital group. The conclusion I came to is as follows: 1: computers are autistic savants which crunch out numbers programmed into them, so the results will depend on who is doing the programming. 2: if the study is requested by hospital administrators and accountants, the results will be geared towards cost-cutting rather than quality patient care (like history, it is written by the victors). 3: it focuses on "best-case scenarios" and ignores the unexpected. Unfortunately the only way we can counter this trend is if we can document actual instances where the patient has been negatively impacted by acuity-based staffing. Of course these incidents are few thanks to the dedication of nursing staff. Need to reach a little further? just carry on streeeetching! Try to convince a hospital administrator of the deep love which Murphy has for hospitals and all you will get is a sore throat.

Staffing by Acuity is a pipe dream.

As long as the economy is in the tank, and the anticipation of cost increases due to changing legislation are precariously looming, the belt-tightening will continue.

Budgets continue to shrink. Staffing is the only cost overhead that is fluid. Acuitiy has made no difference where i work. Reimbursment rates continue to decline. Burn-out will continue to rise creating an artificial nursing shortage. Diseases formerly treated in-hospital are now being treated in rehab and extended care facilities. Many lawsuits are just settled without admission of guilt because it's cheaper than litigation and cheaper than hiring additional staff. It's called the "cost of doing business".

Fifteen to twenty years ago when I was actively involved in staffing and "acuity" numbers they were meaningless. Looks like they still are today. We did the numbers but administration ignored them, rightly so I thought, whether showing too much staff or too little, meaningless!!!!!