Software Tool Matches Nursing Schedule With Patient Needs

When hospitals schedule nursing staff, they face many challenges. These include a nationwide shortage of nurses, the need to comply with mandates of some states to uphold certain patient-to-nurse ratios, pressures to keep overtime and other payroll costs down, and most importantly, meeting the quality of care and safety needs of patients.

Workforce management and talent optimization software tools are often used by hospitals to help tackle some of those challenges, assisting nursing managers to staff shifts and departments more efficiently than manual, paper-based scheduling processes of the past.

But the latest offering in the suite of talent optimization tools from API Healthcare, a provider of human capital management systems for the healthcare sector, takes staffing tools to a new level. The company's latest component, API Healthcare Patient Classification Solution, can help hospitals schedule nursing staff based on near real-time needs or "acuity" of individual patients and patient units.

The software module interfaces with the nursing documentation notes, or "straight HL7," of e-health record systems used in hospital environments, said API CEO J.P. Fingado. Real time feeds from clinical information systems about patient acuity "map" to API's staffing and scheduling tools, he said.

Based on the patient's acuity scores, which generally run from 1 to 5, API's Patient Classification software helps nurse managers schedule shifts based on the mix of patients' needs in any unit, expertise of particular staff members, and allows managers to take into consideration other factors such as patient loads, overtime and outside nursing agency costs, he said.

"If you have a heart surgery patient that's just arrived in the ICU, that patient might need 2-1/2 hours of care by a senior nurse," said Fingado. That information can be crucial to nurse managers scheduling a shift, allowing adjustments to nurse assignments, "minutes before a shift starts," he said.

Insight into patient acuity during the scheduling of staff can provide greater depth of information to nurse managers and clinical staffing coordinators, said Nancy Semerdjian, chief nursing officer of NorthShore University HealthSystem.

NorthShore, which is based in Evanston, Ill., has been using API's software suite for about a year to manage its workforce of 2,000 registered nurses across four hospitals. While NorthShore hasn't deployed the new API Patient Classification module, Semerdjian said insight into patient acuity can help "maximize resources" and improve patient quality of care and outcomes -- while boosting staff satisfaction. That's because information about acuity while scheduling nurses can assist in balancing patient loads based on the skills of particular staff and the medical needs of patients, as well as patient volume and other factors.

"Not all chronic heart failure patients are the same," Semerdjian said. If insight into acuity while scheduling can inform nurse managers that a heart patient "is also a diabetic and sight impaired," that could influence a decision to assign a nurse with particular expertise to care for those conditions during a given shift, she said.

While many hospitals in the U.S. already use patient classification tools to better understand their patient mix, those tools aren't typically tied to comprehensive workforce management systems, said Jim Holincheck, a managing VP of research firm Gartner in an email interview with InformationWeek.

Other vendors, most notably healthcare IT providers, offer various patient classification systems, however, "what is unique about API Healthcare is that they are pairing that acuity data with other data to create better workforce plans and schedules that can improve care and outcomes while better controlling costs," he said. "It's not common to see workforce management vendors offering their own patient classification solutions," said Holincheck.

"Understanding workload helps make sure there is adequate staffing, that the use of contractors is more optimized [since] contractors often fill the gaps when workload is underestimated, and that the appropriate time can be spent with patients based on acuity, [which helps in] improving quality of care and patient satisfaction," he said.

With healthcare reform, it also "appears that in the U.S. the government will want more information about acuity and what that means to workload in the hospital," he said.