New Acuity Staffing Model Draws Wide Praise

With staffing levels now determined by patient acuity, Brittany Borkowski, BSN, RN, is spending more time providing high quality patient care to those who need it most.

With staffing levels now determined by patient acuity, Brittany Borkowski, BSN, RN, is spending more time providing high quality patient care to those who need it most.

In the six weeks since staffing levels based on patient acuity began on all inpatient units, the new API Healthcare Patient Classification system has won favorable feedback from many nurses, specifically around the benefits of enhanced flexibility and patient care delivery.

More thoughtful alignment of nursing assignments to patients’ needs, versus being solely based on the number of patients on a unit, is an evidence-based strategy nurses say is helping them provide the best possible care to their patients.

“Morale seems lifted,” said patient care manager, Catherine Houda MS, RN, NE-BC. “Nurses say they’re spending more time with patients, educating them. The participation rate with the API system is high because nurses know it’s their input that determines staffing needs. Assignments are more equitably distributed. It’s fair and standardized.”

Painstaking care went into achieving that delicate balance. For the UCM Acuity Committee, this important project was much more than a regulatory necessity mandated by the 2007 Nurse Staffing by Patient Acuity Act. The team of staff nurses and mangers gathered input from every level of nursing.

Months of testing, validation, recalibration, piloting of staffing protocols and collaborative work ensured the right processes, technology and support were in place for a successful go-live.

Emily Lowder, PhD, RN, NE-BC

Emily Lowder, PhD, RN, NE-BC

“Flexibility is the essence of what we were driving toward as we implemented this tool,” said Emily Lowder, PhD, RN, NE-BC, Director of Patient Logistics and Acuity Committee co-chair. “The tool allows for recognition of the wide scope of nursing practice and patient care needs.”

Supplemental staff nurse, Brittany Borkowski, BSN, RN, admitted she was a bit skeptical of API’s overall benefit to patients and nurses before the go-live, but six weeks in, she’s been pleasantly surprised.

It’s been nice!” said Borkowski. “I feel I’ve had more good days where adequate staffing has allowed me to get more done, which was sometimes difficult before if I had patients with complicated medication administration or more time consuming hygiene needs. I like that API takes all these demands into account.”

While API has been a welcome addition for Borkowski, she notes opportunities for a few tweaks, such as more indicators to identify patients with a greater risk of falling or a way to adjust for a sudden shift in a patient’s status.

Such feedback is appreciated by the Acuity Committee, which says it will aid continued evaluation of the system along with the defined measures and key indicators. Nurses at all levels will play an active and valued role in identifying opportunities for improvement.

“There’s always something to learn and improvements to be made,” said Lowder. “The successful rollout of staffing by acuity is a great example of nurses working together to achieve optimal patient outcomes and satisfaction.”

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