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Variability in the care delivery process has a direct impact on staff, especially nurses in the hospital setting. Peaks in demand create stresses on staff by increasing the patient care burden beyond acceptable and sustainable levels. Creating or allowing conditions to exist that require nurses to care for more patients than they can adequately care for has a similar , but greater effect , than to a nursing shortage. Peaks in demand often occur suddenly, without warning, making it difficult to compensate and respond to the added care burden. Variability also wastes resources. As most hospitals staff to average demand, valleys in demand mean that staff resources are underutilized, there by leading to a waste. Expenses are wasted. The added care burden on nurses during peaks in demand affect the quality of care. In the manuscript, MVP faculty and colleagues demonstrate and quantify the impact variability in nurses’ patient care burden has on hospital mortality. Addressing variability has a positive impact on staff. The work carried out at Boston Medical Center resulted in a 0.5 hour reduction in nurse hours/patient day. Overtime hours and daily variation in nurse staffing were reduced. As important, staff commented on reduced stress from the operational improvements. Staff and patient satisfaction improved at St. John’s Hospital as well as a result of operational improvements to smooth variability. Their Operating Room overtime is record low. |
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