New API Acuity System Launches in September

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A software system that helps classify the individual care needs of patients will ensure University of Chicago Medicine is providing patients the best possible care while matching staffing to the acuity of patients in every unit.

Staffing allocations related to the API Healthcare Patient Classification system will begin in all inpatient units September 16, following months of testing, validation, recalibration, piloting of staffing protocols, and collaborative work with nurses. The new system will generate acuity data for each unit, and that data will be used to help establish nurse staffing levels at the unit levels that directly correlate to the acuity and nursing assessments of our patients. The software is designed to ensure that we can match our nursing support at the unit level to the individual care needs of our patients, which is far better than a volume-based allocation alone.

Acuity Committee co-chair Marianne Curia, PhD, MSN, RN, NICU staff nurse, says the team took measures to collect input from all levels of the hospital’s nursing community in the important effort toward more equitable nurse-to-patient assignments.

The acuity system was selected by UChicago Medicine nurses after a searching review for the system that could best capture data on the complex and varied needs of individual patients while ensuring that we empower nurses to apply their clinical judgment to set appropriate staffing levels.

“After the acuity system was selected by stakeholder vote, staff nurses from every unit worked with API to develop the UCM-specific tools validated by time studies,” said Curia. “Over the last several months, we’ve solicited changes from all staff nurses and once again validated the tools. Now, we’re finally ready to staff by them.”

The optimal amount of time a nurse requires to deliver high-quality care varies greatly with the needs of the individual patient. And the constant flux of patient care demands makes nurse staffing and scheduling a complex issue for health care organizations across the country. Over the last decade, researchers have come to better understand this complexity and have developed increasingly complex models and programs like API that deliver th most appropriate staffing levels and the best patient outcomes without having to resort to wasteful and inaccurate staffing practices premised solely on the number of patients on a unit.

Because consistency is key to the effective rollout of staffing by acuity, super users, or staff nurses with more extensive training on the acuity tools, were devoted to roam the units and help ensure others understand the application and can utilize it appropriately and accurately. Also essential, the committee says, is continued communication between staff nurses and managers.

“An optimal staffing model requires an approach that recognizes the wide scope of nursing practice and patient care needs,” said Emily Lowder, PhD, RN, NE-BC, Director of Patient Logistics and Acuity Committee co-chair. “We believe nurses will find the new system is equitable and standardized. And most importantly, nurses will be more empowered to make decisions in regards to the appropriate level of care for their patients.”

As with any new process, measures and key indicators will aid in continued evaluation. Nurses at all levels will play an active and valued role in identifying any opportunities for improvement.

“Research tells us that matching a patient’s acuity with the appropriate skill mix will improve patient care,” said Curia. “Of course, utilization of the system in this manner is a first for UChicago Medicine so the jury is still out, but we feel confident.”

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