In healthcare, we’re constantly striving to optimize the care delivered to patients. Data and technology are two of the most powerful tools we have in achieving this goal, and luckily, we have greater access to both than ever before. With the right data in the right place at the right time, we can make more informed decisions in care delivery and operations – providing more value and better outcomes.
In 2017, when I was working as the nursing director of a major metropolitan children’s hospital, my colleagues and I looked to data to better understand the actual cost of nursing care at an individual patient level rather than by unit or hospital. Traditionally, the cost of nursing was grouped with the room and bed charge and viewed as an expense. That left nursing budgets more vulnerable to cost-cutting measures and staffing inadequately determined by patient numbers instead of patient needs and nurse expertise.
We launched a study examining 1,700 nurses and 44,000 pediatric patient encounters. We gathered deidentified patient outcomes data from the Cerner electronic health record and compared it to the patient acuity, staffing and scheduling information in the Cerner Clairvia® workforce management solution. Clairvia enabled our staff to better manage workforce needs and planning with features such as:
- capturing patient-specific care data across the continuum
- projecting average length of stay based on a patient’s diagnosis
- predicting discharge dates
- aligning anticipated patient progression with workload forecasting
- automating smart assignments based on nurse competencies, continuity of care, patient needs and projected transitions of care
With robust, real-time data at our fingertips, we were able to move beyond anecdotal stories to get a precise picture of what was happening in our organization around staffing, workload, outcomes-based acuity and costs. For example, we found that:
- Direct nursing costs per patient per 12-hour shift were 91% greater for a critical care registered nurse (RN) versus a medical-surgical RN.
- Assigned demand hours increased by length of stay (shift). The longer a patient stayed in the hospital, the more care hours they needed since sicker patients stay in the hospital longer.
- We could identify the specific reasons for a 14.7% growth in nursing costs over three years.
- Some medical-surgical units have patient acuity outliers as high as the intensive care unit, which can lead to higher-than-expected hours of care.
Hospitals of all sizes can gain actionable data from health IT. I’m grateful for the findings we discovered, and I strongly believe we must continue this type of research across the industry to account for value from individual nurses. This is critical as we work to advance data-driven decision making around care delivery and operations and advocate for policy changes for reimbursement.
Cerner is committed to delivering automated and intelligent solutions for healthcare organizations to provide the best care at the lowest cost. Learn more here.
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