Journal Article

HARMONIZING FINANCE & NURSING LEADERSHIP: REMIX YOUR STAFFING WITH A 4-HOUR BEAT. HOW AN INNOVATIVE REAL-TIME STAFFING ANALYSIS USING FOUR-HOUR ASSESSMENTS LED TO COLLABORATION AND PARTNERSHIP WITH THE DEPARTMENT OF NURSING AND CHIEF FINANCE OFFICER (CFO)

Magagna, Amy, Passio, Christina, Rodriguez, Anna Liza

2024

Overview

Fluctuating patient needs, coupled with an ever-present nursing shortage, galvanize nurse leaders with ative model challenges and budget variances, necessitate prompt evaluation to adapt to the organizational staffing needs. An innovative tool, created to conduct real-time variance analysis, has empowered frontline leaders with an ability to analyze as well as adjust the staffing matrix. The development of a staffing analysis workbook to capture current staffing plans, census data, and targeted nursing hours per patient days (HPPD) was designed to assess staffing decisions, incorporate nursing skill mix, patient acuity, and shift from the traditional 12-hour staffing paradigm. Assessing staffing in four-hour increments optimizes resource allocation thus adapting to patient throughput throughout the day and reduces unnecessary labor costs due to overstaffing during lower census periods. A comprehensive staffing analysis workbook afforded live input of staffing, census, and acuity data in four-hour intervals. The workbook was equipped with preset values for targeted RN HPPD and total HPPDs, facilitated the calculation of actual HPPDs, and initiated variance analyses. Color-coded indicators simplified budget assessments, aiding supervisors in decision-making during off peak hours pertaining to staff deployment. An enhanced ability to assess, evaluate, and promptly alter staffing decisions was established. Daily variances in staffing and budget discrepancies were reduced, contributing to improved fiscal accountability. Trends in hourly, daily, and weekly census were identified while considering patient acuity and promoting greater resource allocation and efficiency. Sharing with the finance team provided valuable insights into the fiscal impact of staffing decisions. This tool improved overall staffing practices and strengthened the relationship between nursing leadership and the finance team. Through a collaborative approach, a deeper understanding of the interplay between clinical and financial factors was fostered, resulting in informed and strategic decisions. The collaboration culminated into a biweekly meeting with the CFO to review positions, based on accurate assessment of operational needs. The initiative revolutionized the analysis of nursing staffing by transcending from the 12-hour staffing model to real-time assessments in four-hour increments. Improved utilization of resources was ensured through assessing the appropriate number of staff that is available at critical times. By enriching the financial acumen of frontline nursing leaders, a culture of fiscal accountability was formed, bolstering the partnership between nursing leadership and finance. The strengthened professional relationship exemplifies optimal changes across healthcare organizations.

• Publisher: Oncology Nursing Society
• Subject: Accountability / Censuses / Collaboration / Decision making / Leadership / Nursing / Nursing care / Oncology / Professional relationships / Workforce planning