BIT 1025

Hospital Management
Dr. Arunkumar Chandrasekhar, MRSC
KGSP Fellow
Assistant Professor [Sr.]
School of Electronics Engineering
Department of Sensors and Biomedical Engineering
Vellore Institute of Technology
E-mail: arunkumar.c@vit.ac.in
1
Staffing
 Definition of staffing
Staffing refers to the number and mixture of personnel
assigned to work in nursing units at a given time
Goal of staffing
The goal of staffing is to provide an adequate number
and mixture of personnel to give proper care to the
patients in the nursing units at a particular time

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 Staff classification
Professional nurse: Bachelor's degree
Technical nurse: Secondary Technical Nursing School( Diploma
degree)

Auxiliary: messenger and transport personnel

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 Components of Staffing
Staffing pattern:
It is the number and mix of personnel that should be on
duty per each unit per shift, per day

Staffing plan:
It determines the number of nursing personnel that
must be hired to deliver nursing care on the nursing
units
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 Methods of determining the staffing pattern

The traditional system

The number of beds per unit ( one nurse per 4-6 beds),
or
The average census of patients per
unit ( one nurse per 4 patients)

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 The distribution of nurses is based on the nurse manager opinion of
the proportion of care that is needed on each shift and the adequate
staff number to provide that care
Example: Days: 45% of the staff
Evenings 35% of the staff
Nights 20% of the staff
The traditional system ignored that the group of patients
might need more care than another group of the same number
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 The advanced system

1] Patient Classification

2] Task Quantification

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 Patient classification
✓Focuses on patient needs
✓Patients are grouped according to the acuity of their
needs and the degree of their dependency on nurses
✓The patients grouped according to their nursing needs
into 3 or more groups,
Group 1: Self care
Group 2: Partial or intermediate care
Group 3: Intensive or total care
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 Task quantification system
✓Focuses on nursing tasks to be performed
✓ Common nursing tasks are either direct nursing care ( in the
presence of the patient as in giving medication, measuring vital
signs…..) or indirect nursing care ( away from the patients as in
preparing medication , documentation in patients‘ files, giving
instructions or educative sessions……)

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 Methods for use of supplementary staff

1- Borrowing method

2- Floating staff ( floating pool)

3- On-call staff

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 Nursing organization factors:
• Patient care objectives
• Determined level of patient care
• Assignment system
Patient factors
• Acuity and general health status
• Length of stay
• Patient number
• Age group (pediatrics or adult)
• Care expectations of patients

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 Factors affecting staffing pattern determination
Staff factors
• Educational level of the nurses
• Experience level of the nurses
• Staff number
• Job description of each category of nurses

Health organization factors

• Budget available
• Personnel policies regarding work time
• Support services with the organization
• Number of beds
• Architecture design of the units

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 Methods of determining the staffing plan
The staffing plan
Using calendar days
Divide the number of days in a year by the number of days actually worker per
nurse per year
Nurses are not working the 364 days of the year , but actually working 272 days
only in a year, because the rest 92 days are considered as follows:
- Number of days off (1 day off per week) 52 days
- Number of vacation days 20 days
- Number of ill days ( hosp.policy) 10 days
- Number of holidays 10 days
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92 days
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 Methods of determining the staffing plan
Total actual work days = 364 - 92 = 272 days
Number of nurses needed to fill one position of staff nurse =
Number of days in year
------------------------------------
Number of actually worked days

364/ 272= 1.33 nurses that means you will need 1.33 nurse to fill one
position
Then calculate the total number needed for staffing pattern for all units

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 A system of shift differential is established to
compensate for hours worked in evening and night
(30% more salary).

The same compensation applies to work during

holidays.
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 Using the care hours for developing staffing pattern
Hospitals used the patient care hours for developing staffing pattern, can calculate the
staffing plan using the care hours methods.
For example:
Estimating a core staff per shift
Bed number in surgical unit= 25 bed
The average daily census for 6 month = 19 patients
The average daily care hour to be provided= 5 hour per pt/24 hour
Total hours of care will be needed= 19x5= 95 hours
If the work day is 8 hours , then 95 divided on 8
= 11.9 or 12 FTE staff needed to unit for 24 hour
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 Total of 12 FTE x 7 days / week = 84 shift / work
If the employee work 5 hours shift / week, then 84
5 = 16.8 the number of FTE needed.
The needed on each shift and the adequate staff number to provide that care.
Example: days: 45% of staff
45x16.8/100=7.56 = 8
Evenings 35% of the staff
35x16.8/100=5.88 = 6
Nights 20% of the staff
20x16.8/100=3.34 = 3

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