NUR 621 What type of staff performance indicators would you monitor to ensure you were meeting your budget?

The healthcare industry is constantly changing, and healthcare organizations must ensure standards are maintained and monitored to thrive and function successfully. Healthcare indicators help monitor how well organizations are functioning and show areas that need improvement. “Key performance indicators are quantifiable measurements that show how well an organization, team, or individual is performing against a predetermined goal or objective” (Mind Tools, n.d.). Performance indicators measure how well healthcare organizations operate in managing utilization which is the demand for services by consumers (Penner, 2017). Financial indicators measure the monetary values in healthcare organizations (Penner, 2017). Healthcare facilities must create a balance in ensuring the best patient care while managing staffing, resources, and associated costs. Some significant performance indicators to consider ensuring facilities stay within budget are staff-to-patient ratio, bed occupancy rate, average hospital stay, treatment costs, patient satisfaction, and employee satisfaction. To monitor performance indicators, facilities must track records and progress, generate reports and compare to see if any improvement is needed; doing so helps to ensure positive patient outcomes and organizational success.

References

Mind Tools. (n.d.). Performance management and KPIs. https://www.mindtools.com/pages/article/newTMM_87.htm#:~:text=A%20Key%20Performance%20Indicator%20(KPI)%20is%20a%20quantifiable%20measurement%20that,a%20predetermined%20goal%20or%20objective.

Penner, S. J. (2017). Economics and Financial Management for Nurses and Nurse Leaders (3rd ed.). Springer Publishing Company. ISBN: 978-0-8261-6001-0

I agree, healthcare is always changing. New discoveries are being made everyday. Healthcare organizations need to adopt this changes so as to provide up to date care that is effective to their patients and cost effective. This changes require a lot of resources to adapt to, and it is up to healthcare organizations to decide which changes are worth while to adopt. How well the company manages it finances does determine the pace to which change does take place.

Healthcare organizations should also aim to improve employee satisfaction by giving them a conducive place to work, and offer them competitive wages. Patient satisfaction should also be a priority for any healthcare organization. Patients should be made to feel that their healthcare needs are met, and they should be involved in their treatment plan. Healthcare organizations should always strive to make improvements on their service delivery to their patients and their workers as a whole (Selim et al.,2018)

Reference:

Selim Ahmed, Noor Hazilah Abd Manaf, & Rafikul Islam. (2018). Measuring Lean Six Sigma and quality performance for healthcare organizations. International Journal of Quality and Service Sciences, 10(3), 267–278. https://doi.org/10.1108/IJQSS-09-2017-0076

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Most healthcare organizations require a lot of financial resources to operate. Since they provide services to their patients, they require a lot of human labor in order to provide adequate health care services to their patients. This normally requires a lot of financial planning in order to have these organizations continually running. A budget needs to be in place and adhered to, so as to keep the healthcare organization functioning and running efficiently with enough resources. One of the methods that most hospitals use is by using dashboard. Dashboard is used to show the number of unoccupied and occupied beds in the hospitals. By using this tool, the hospital is able to utilize all staffing and managed patients flow more effectively. The healthcare organization would also track the quality of care that is being provided in various units. This ensures that patients receive quality care and are satisfied with the care that they receive. The other method is to monitor the effectiveness of new treatments. This will ensure that the patients are getting better once they are admitted to the hospital. It will also give the opportunity to the hospital to identify which treatments have the best results. The other reason is to increase operational efficiency in the healthcare organization. This will not only increase savings, but it will also increase operational efficiencies (Selim et al., 2018)

Reference:

Performance indicators are used by companies to increase performance levels. Quality metrics can improve performance management in creating a high performing team that measures employee productivity. Key performance indicators (KPI) are a quantifiable measure of performance over time for a specific objective. They provide goals for teams to strive towards, milestones to measure progress and insights to help those involved across the organization make better informed decisions (Penner, 2016). There are four types of performance measures that include workload or output, efficiency, effectiveness or outcome measures and productivity (Hunt & Hartman, 2018).

Healthcare is an industry that is always evolving and is labor driven. It requires a collaborative effort from physicians, nurses, interdisciplinary teams such as occupational therapy and physical therapy, social work, nutrition, nurses’ aides, unit secretaries and technicians of all skill levels. It is a 24-hour shift that never stops and requires staffing for all shifts from days to nights (Penner, 2016). A staffing indicator would measure the workload of each shift, the acuity and staffing required. According to KPI would include the units bed occupancy, projected and actual length of hospital stay which reflect patient volume and even the costs for treatment. All of these indicators reflect the financial success of the unit and how well it is functioning and relays a message to management as to how well the team is doing. Other ways to monitor could include readmission rates, patient satisfaction, mortality rates and hospital incident or safety issues. The goal of performance indicators would be to identify opportunities for reducing costs, improving the quality of care and increasing efficiency of care delivery given as well as care outcomes.

Performance measurements are a way in which to provide data on what is working and what isn’t, identify gaps in care and change the areas that need improvement (Simou, Pliatska, and Roumeliotou, 2014). It also can recognize and reward above average performances to help create the best practice. The measurements also emphasize the value of patient centeredness and safety while assessing the quality of the clinical pathways needed in order to deliver high quality patient focused care.

Hunt, P. S. & Hartman, D. (2018). Meeting the measurements of inpatient staffing productivity. Nursing Management (Springhouse), 49(6), 26-33.

Penner, S. J., RN, , MN, , MPA, , DrPH, , & CNL, . (2016). Economics and financial management for nurses and nurse leaders (3rd ed.). Springer Publishing Company.

Simou E, Pliatsika P, Koutsogeorgou E, Roumeliotou A., (2014). Developing a national framework of quality indicators for public hospitals. Int J Health Plan Management. 29(3):e187–206. https://doi.org/10.1002/hpm.2237

Nursing staffing performance has an essential impact on the budget. Throughout this entire COVID-19 pandemic nursing units have had increased challenges with maintaining the budget from a staffing standpoint. According to KPI (n.d.) there are a variety of different types of key performance indicators. As a nurse manager I would monitor a balance of strategic measures including customer/stakeholder, financial, and internal processes; along with employee measures with behaviors and skills needed to be successful (KPI, n.d.). Managing cost budgets are essential to help recognize all cost sources to be fully accountable for expenses that are generated on the nursing unit (Penner, 2017). Throughout this pandemic my organization has had to hire many agency nurses with contracts to help fill gaps throughout our staffing scheduling. Not only does this increase expenses, it also can reflect upon performance depending on the agency nurse that we were given to make sure they are competent and follow the vision and values of our organization when delivering safe quality of care to our patients. It is important for all staff to understand and be knowledgeable of what is expected of them from the time they punch in to start their shift till the time they punch out. Staff performance indicators that I would monitor would be overtime, productivity, patient satisfaction, and peer reviews. There are all important to monitor and will reflect the budget negatively if they consistently are showing overtime which could reflect nurse needs to improve time management skills and/or is not being productive at work. If the same staff continuously punches out early this can reflect that the nurse may not be helping team members out and giving adequate sign off reports which can reflect negatively as well. It is important for there to be a balance within staff performance indicators and reflection within the budget for the organization to operate smoothly.

References

KPI. (n.d.). What is a key performance indicator (KPI). https://kpi.org/KPI-Basics

Penner, S. J. (2017). Economics and financial management for nurses and nurse leaders (3rd ed.). Springer Publishing Company.

Nursing performance has a great effect on a budget as you stated, the sheer cost of paying nursing wages is a large percentage of an organizations and unit’s budget. Nursing effects budget by appropriate ratios, outcomes, and efficacy. Nurse specific quality metrics to monitor are to ensure quality, four indicators that related to patient outcomes as a result of safe nurse staffing are pressure ulcers, medication administration errors, Falls, and meeting patients nursing needs ( Butler et al., 2019). Higher quality of care decreases the cost of care by lower adverse outcomes and higher reimbursement rates. Also, as you stated one cannot neglect the productivity related to nursing by monitoring OT, Productive work, turnover and absenteeism, these are all factors that are related to appropriate staffing levels which can affect a budget greatly. An appropriate staff mix is critical to decreasing costs and improving quality, yet nurse managers need to carefully think increased staffing does not always relate to improved quality, a delicate balance of appropriate safe staffing levels is an art nursing leaders can practice to perfect.

thanks for the post

Butler, M., Schultz, T. J., Halligan, P., Sheridan, A., Kinsman, L., Rotter, T., Beaumier, J., Kelly, R., & Drennan, J. (2019). Hospital nurse-staffing models and patient- and staff-related outcomes. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.cd007019.pub3

Key performance indicators (KPIs) are tangible values that indicate how successfully an individual, team, or organization is achieving an organizational goal. Organizations use KPIs to assist people at all levels in concentrating their efforts around a single plan. KPIs also assist firms in determining if they are allocating their time, money, and talent to the most effective strategies, activities, and tools for achieving their objectives. It is usually articulated in progress toward the organization’s long-term objectives (Prose on Genesis Framework, 2019). The KPI includes information on each measure’s sources, computations, and definitions, as well as a schedule for monthly data input. KPIs aid in identifying and tracking progress toward a company’s goals and objectives. After assessing its mission and determining its goals, an organization must keep track of its progress toward those goals. KPIs are used to track and measure performance. KPIs may assist a company in assessing if it is on its way or moving toward attaining a desired goal or improvement. In projects and to analyze service quality, KPIs are often utilized. KPIs can give essential inputs for impact evaluation. Still, unless the organization’s efforts provide a direct, quantifiable output, such as sales results or immediate cost savings, they do not provide enough data to analyze and measure the organization’s beneficial influence (KPI, 2019). KPIs nearly always require some qualitative analysis to fully comprehend the reasons behind the trends and outcomes shown by the KPIs. Plan how the organization will capture the information needed when executives decide which KPIs to put up.

Net profit, for example, requires a separate collection of data and access to other systems than customer happiness. Determine who will gather the data and how often. For example, sales data can generally be obtained daily, but KPIs that need data from several sources may be better assessed weekly or monthly (Chamber of Commerce of Metropolitan Montreal, 2019). Leaders will also need to double-check the data to ensure it is correct and meets all KPI standards. Communicate KPIs to all parties involved. Determine who is in charge of each team or organizational KPI, and ensure that all reports understand how each KPI affects their job and which tasks to prioritize. Leaders may put up a performance dashboard or employ a balanced scorecard to monitor success effectively.

Chamber of Commerce of Metropolitan Montreal. (2019). Measure performance and set targets. Info Entrepreneurs.org. https://www.infoentrepreneurs.org/en/guides/measure-performance-and-set-targets/

KPI. (2019). What is a Key Performance Indicator (KPI)? Kpi.org. https://kpi.org/KPI-Basics

Prose on Genesis Framework. (2019). Key Performance Indicators (KPI) | Examples, Guide, and Process Explained. Application Performance Management. https://www.applicationperformancemanagement.org/performance-testing/key-performance-indicators/

Health care is labor intensive, requiring the ability and efforts of nurses and other health care providers to assess and manage the care of consumers needing health care services. In outpatient and community-based settings, staffing is often relatively simple and like work settings in industries other than health care. Inpatient care staffing is more complex and costly than in outpatient settings. Inpatient care must be provided 24 hours a day and 7 days a week. Staff scheduling requires assigning multiple shifts and coverage for weekends and holidays (Penner, 2016).

Staffing indicators measure the workload and labor needed for providing health care services and are typically reported in more detail for inpatient staffing compared with outpatient staffing. Inpatient staffing and scheduling typically occur at the micro-system level, which is often the nursing unit or a work setting, such as the emergency department. In many industries, employees work a standard full-time job position or defined occupation within the employing organization. Job positions may define the staffing in many outpatient and community-based settings in which nurses work. An earlier example describes three NPs (Nurse Practitioners) who each have a job position working 40 hours a week at a nurse-managed health center (Penner, 2016).

Many employees assigned to job positions are paid based on an annual salary, or compensation that does not change regardless of the number of hours worked over the year. Job positions are simple to measure and report, representing a count of the number of employees working in each setting. A standard measure for hourly employment is the full-time equivalent (FTE), indicating a full-time employee working 8 hours a day and 5 days a week, for 52 weeks (about 12 months) a year, for a total of 2,080 hours per year. An employee working 1.0 FTE might fill a job position (Penner, 2016).

However, an employee assigned to an FTE is likely to earn an hourly wage, or compensation based on the number of hours worked. FTEs enable the accurate measurement of hours and compensation for employees working part time, or less than 1.0 FTE. The FTE also allows the measurement of overtime or other hourly rates. Fixed FTEs resemble job positions and are also referred to as permanent staffing or indirect staffing. Fixed FTEs are often reported by inpatient settings to represent staff hours scheduled regardless of patient volume (Penner, 2016). I would manage these key indicators on a weekly basis to ensure a need for overtime and added staff is needed. I would use the organizational software with Microsoft Excel and keep a close monitoring eye on trends. (Government Finance Officers Association, 2022)

Reference

Penner, S. J., RN, , MN, , MPA, , DrPH, , & CNL, . (2016). Economics and financial management for nurses and nurse leaders (3rd ed.). Springer Publishing Company.

Performance Measures. (2022). Government Finance Officers Association. http://gfoa.og

NUR 621 What type of staff performance indicators would you monitor to ensure you were meeting your budget?