Staffing Matrix

*EXAMPLE* Benchmark – Staffing Matrix and Reflection

Performance management of a healthcare institution depends on the efficient management of human resources. Having the availability of qualified personnel, productively working in the appropriate areas enhances both outcomes and quality of patient care (Thériault et al., 2019). The paper aims to discuss the benefit of adopting a staffing matrix in a healthcare setting, describes a staffing matrix plan and the changes that might be required compared to the patient census, and creating a variance report to reallocate resources according to needs.

Importance of a Staffing Matrix

A staffing matrix is an essential and indispensable aspect of the allocation and resource utilization within the healthcare setting. Numerous units adopt various staffing matrices to certify there are no replications within the unit’s employees and resources. The staffing matrices offer the advantage of providing a clear vision concerning the management of the unit’s personnel. Also, the requirements of the unit together with the policies of financial management and the allocation and resource utilization ((Dagestad & Grassley, 2019). Staffing matrix assists in determining and assigning the daily patient care and duties required in a nursing unit. It offers a clear image of the working personnel schedule to permit for an appropriate mix of nursing care to patients’ requirements instead of being reactive for each shift (Johnson-Carlson et al., 2017).

A staffing matrix assists in budget determination associated with human resources and allocation of finances and assists in preventing funds wastage. Financial principles are applied to obtain a more robust understanding of the allocation of the unit’s finances. Another importance of the staffing matrix is that it ensures enhanced patient care quality by providing highly skilled trained nursing personnel that equals patient’s understanding.

Staffing Matrix Description

The staffing matrix shown in the provided excel template lists the daily census for a week and achieves a 90% occupancy percentage. With staffing established at twelve hours shifts, the Full-Time Equivalent (FTE) direct nursing coverage aspect for a twenty-four hours duration is 4.7 nursing FTEs. Fixed staffing for this section comprises the manager, nursing in charge, and the health unit coordinator. Therefore, unit staffing will be based on the patient occupancy percentage, hours per patient day (HPPD) based on the patient understanding in this context approximated at 360, and a nurse-to-patient ratio based on patient acuity and occupancy. The initial five days of the matrix reduce the daily tally by one patient per day, commencing with 30 patients and reducing by one to 26 patients. Staffing on these five days could exhibit the requirement of one health unit coordinator (HUC), seven registered nurses (RNs) per shift, and three certified nursing assistants (CNAs). Skill blend is not a problem for the matrix since the primary nurses are RNs. The matrix will enable a nurse-to-patient ratio of one registered nurse to five patients (1:5), one RN as a resource and for patient admissions, release, and transfers (ATDs), and one CAN to ten patients (1:10). The remaining two days of the matrix on the patient a day reduces to 25 and 24 correspondingly. Staffing for the two days will result in a decline in RN and CNAs handling to six and two, respectively. The staffing decline will level the occupancy rate and continue to permit the same RN staffing ratio.

The usage of the staffing matrix should enable improved patient safety by ensuring adequate staffing and an additional increase of RN personnel. The RN will help when the need arises in the unit and allow the primary care RNs to remain on the unit instead of dealing with patient transfers. The staffing matrix improves staff morale and job satisfaction by minimizing the nurse-to-patient ratio. It will ensure that the nurse doesn’t consider they are being stretched to their limits. Hence, it can lead to colossal personnel retention, overcoming the need for agency nurses that will incur the unit a substantial budgetary cost. The financial management principles to design the matrix involves staffing (number of staff needed per day), patient capacity, and utilization in terms of HPPD.

Staff Adjustments

Variations in patients’ numbers need changes to the staffing matrix. Patient census happens at midnight each night to reflect the minimal patient activity. Full patient bed capacity requires a single in-charge nurse, seven RNs, one resource RN, three CNAs, and one HUC. Staffing will differ depending on the daily patient acuity and number. To sustain the nurse-to- patient staffing ratio, a reduction of five patients will decline the RN personnel by one nurse. The nurse who isn’t required for the day might be shifted to another section or in charge of calls if patient acuity is required. Adjustments in inpatient acuity might be a patient on extracorporeal membrane oxygenation (ECMO) that would need a ratio of one nurse to two patients.

Budgetary issues also influence the staffing matrix. A minor patient census could demand a decline in staff or floating nurses to other sections or placement of nurses on-call when necessary. A nurse placed on-call approximately earns $5 per hour while receiving calls and earns time and a half when called in. such scenarios have two side effects on the budget. 1) personnel are paid for not going to work, meaning the funds coming from the budget minus productivity to account. 2) If the staff reports to work, they no longer earn at the base rate but are paid at a time and a half rate. It indicates that a nurse is usually paid $33 per hour, and currently, they will earn $49.50 per hour minus formerly accomplishing their forty hours to attain over time.

Reallocation of Resources Based on Staffing Variance

Restructuring of personnel and alteration for variances are usually essential to continue within the budgetary limits for staffing. The initial step to make when encountering exploitation of FTEs is the evaluation of the staffing matrix to guarantee the in-charge nurse compliance with the unit plan for staffing to certify appropriate staffing resources are utilized based on the patient acuity and census. Personnel utilization for the suitable role should be reviewed since an individual could not desire an RN in the role of a sitter. In contrast, it will be more sensible to allocate the duty to the CAN. Another section that should be reviewed is the employee expenditure report. Actual performance should mirror the proper usage of HPPD over time. Direct care that is a surplus of HPPD might indicate the patient acuity is more significant than the original budget or nursing care isn’t being delivered correctly. Focus on the unit of service could also be needed. An upsurge or decline in inpatient days should reflect an effective incline or decline in personnel hours and expenditures (Penner, 2017).

Conclusion

Patient requirements and a balance of unit resources are crucial in the management of the staffing matrix. The nurse manager should balance the needs of each staff member, nurse to patient ratios, and suitably expert staff, and budget limits. Since all these factors might lead to frustrations, the development of a strong staffing matrix and continuous review for

References

Dagestad, A. J., & Grassley, S. (2019). Embracing Change by Moving Forward With an Activity-Based Staffing Matrix. Journal of Obstetric, Gynecologic & Neonatal Nursing, 48(3), S73.

Johnson-Carlson, P., Costanzo, C., & Kopetsky, D. (2017). Predictive staffing simulation model methodology. Nursing Economics, 35(4), 161.

Penner, S. J. (2017). Health policy and future trends. In Economics and Financial Management for Nurses and Nurse Leaders (3rd ed., Ch 15).

Thériault, M., Dubois, C. A., Borgès da Silva, R., & Prud’homme, A. (2019). Nurse staffing models in acute care: A descriptive study. Nursing open, 6(3), 1218-1229.

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