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Capacity management of nursing staff as a vehicle for organizational improvement.
BMC Health Serv Res. 2007 Nov 30; 7:196.BH

Abstract

BACKGROUND

Capacity management systems create insight into required resources like staff and equipment. For inpatient hospital care, capacity management requires information on beds and nursing staff capacity, on a daily as well as annual basis. This paper presents a comprehensive capacity model that gives insight into required nursing staff capacity and opportunities to improve capacity utilization on a ward level.

METHODS

A capacity model was developed to calculate required nursing staff capacity. The model used historical bed utilization, nurse-patient ratios, and parameters concerning contract hours to calculate beds and nursing staff needed per shift and the number of nurses needed on an annual basis in a ward. The model was applied to three different capacity management problems on three separate groups of hospital wards. The problems entailed operational, tactical, and strategic management issues: optimizing working processes on pediatric wards, predicting the consequences of reducing length of stay on nursing staff required on a cardiology ward, and calculating the nursing staff consequences of merging two internal medicine wards.

RESULTS

It was possible to build a model based on easily available data that calculate the nursing staff capacity needed daily and annually and that accommodate organizational improvements. Organizational improvement processes were initiated in three different groups of wards. For two pediatric wards, the most important improvements were found to be improving working processes so that the agreed nurse-patient ratios could be attained. In the second case, for a cardiology ward, what-if analyses with the model showed that workload could be substantially lowered by reducing length of stay. The third case demonstrated the possible savings in capacity that could be achieved by merging two small internal medicine wards.

CONCLUSION

A comprehensive capacity model was developed and successfully applied to support capacity decisions on operational, tactical, and strategic levels. It appeared to be a useful tool for supporting discussions between wards and hospital management by giving objective and quantitative insight into staff and bed requirements. Moreover, the model was applied to initiate organizational improvements, which resulted in more efficient capacity utilization.

Authors+Show Affiliations

Department of Innovation and Process Management, Academic Medical Center/University of Amsterdam, Amsterdam, The Netherlands. s.g.elkhuizen@amc.uva.nlNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18053136

Citation

Elkhuizen, Sylvia G., et al. "Capacity Management of Nursing Staff as a Vehicle for Organizational Improvement." BMC Health Services Research, vol. 7, 2007, p. 196.
Elkhuizen SG, Bor G, Smeenk M, et al. Capacity management of nursing staff as a vehicle for organizational improvement. BMC Health Serv Res. 2007;7:196.
Elkhuizen, S. G., Bor, G., Smeenk, M., Klazinga, N. S., & Bakker, P. J. (2007). Capacity management of nursing staff as a vehicle for organizational improvement. BMC Health Services Research, 7, 196.
Elkhuizen SG, et al. Capacity Management of Nursing Staff as a Vehicle for Organizational Improvement. BMC Health Serv Res. 2007 Nov 30;7:196. PubMed PMID: 18053136.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Capacity management of nursing staff as a vehicle for organizational improvement. AU - Elkhuizen,Sylvia G, AU - Bor,Gert, AU - Smeenk,Marjolein, AU - Klazinga,Niek S, AU - Bakker,Piet J M, Y1 - 2007/11/30/ PY - 2007/04/27/received PY - 2007/11/30/accepted PY - 2007/12/7/pubmed PY - 2008/3/6/medline PY - 2007/12/7/entrez SP - 196 EP - 196 JF - BMC health services research JO - BMC Health Serv Res VL - 7 N2 - BACKGROUND: Capacity management systems create insight into required resources like staff and equipment. For inpatient hospital care, capacity management requires information on beds and nursing staff capacity, on a daily as well as annual basis. This paper presents a comprehensive capacity model that gives insight into required nursing staff capacity and opportunities to improve capacity utilization on a ward level. METHODS: A capacity model was developed to calculate required nursing staff capacity. The model used historical bed utilization, nurse-patient ratios, and parameters concerning contract hours to calculate beds and nursing staff needed per shift and the number of nurses needed on an annual basis in a ward. The model was applied to three different capacity management problems on three separate groups of hospital wards. The problems entailed operational, tactical, and strategic management issues: optimizing working processes on pediatric wards, predicting the consequences of reducing length of stay on nursing staff required on a cardiology ward, and calculating the nursing staff consequences of merging two internal medicine wards. RESULTS: It was possible to build a model based on easily available data that calculate the nursing staff capacity needed daily and annually and that accommodate organizational improvements. Organizational improvement processes were initiated in three different groups of wards. For two pediatric wards, the most important improvements were found to be improving working processes so that the agreed nurse-patient ratios could be attained. In the second case, for a cardiology ward, what-if analyses with the model showed that workload could be substantially lowered by reducing length of stay. The third case demonstrated the possible savings in capacity that could be achieved by merging two small internal medicine wards. CONCLUSION: A comprehensive capacity model was developed and successfully applied to support capacity decisions on operational, tactical, and strategic levels. It appeared to be a useful tool for supporting discussions between wards and hospital management by giving objective and quantitative insight into staff and bed requirements. Moreover, the model was applied to initiate organizational improvements, which resulted in more efficient capacity utilization. SN - 1472-6963 UR - https://www.unboundmedicine.com/medline/citation/18053136/Capacity_management_of_nursing_staff_as_a_vehicle_for_organizational_improvement_ L2 - https://bmchealthservres.biomedcentral.com/articles/10.1186/1472-6963-7-196 DB - PRIME DP - Unbound Medicine ER -