In the heat of the summer, let’s talk about staffing data!
I was just perusing the July 2024 edition of Perspectives and I found myself somewhat puzzled by the Consistent Interpretations column, which, in this case, focused on the requirements relating to the analysis and assessment of data on the adequacy of staffing. While the focus is very much on nursing and other clinical services (as they make up the majority of the healthcare workforce), there’s no reason to think that the requirements might not be applied to other pursuits—perhaps, environmental services, food and nutrition services, plant operations, etc. As I think about how this all ties back to the management of the physical environment—and, rest assured, it does—I am reminded of the importance of the “fixers” in any healthcare organization and how the support resources can ebb and flow depending on how busy it is, where folks are in the orientation process, etc. If you’re generally familiar with the Consistent Interpretations column, it features compliance data based on whichever time period was used as the data source. In this instance, survey year 2023 was the source (1,300+ entities were surveyed during that time), and the overall level of compliance was pretty darn good; the 99th percentile or above for each of the three cited standards.
That level of performance leads me to the other point that popped into my head. Can we presume that there may be more focus on how—and how well—we are managing staffing adequacy as a function of data use? To me, it seems (at least) odd to spend time discussing an issue that would appear to be under control, unless it is a way to (oh so gently) redirect the survey process toward a more thorough accounting of healthcare organizations’ efforts to ensure the adequacy of staffing. Clearly (or at least it is to me) any actual occurrence or near-miss reported could have a component related to staffing. So, does this become an area of questioning that must be hardwired into any root-cause analysis or even a failure mode & effects analysis (good resource for how the Feds look at this process)? I suspect that, at least in the short term, it probably is. Staffing is more than a function of just numbers. It’s having the right mix of the numbers—the right competencies, the right level of oversight. The work of healthcare beyond providing care is ensuring that we minimize failures, but to always be in a position to learn from the failures that might occur. To my mind, the only thing worse than a failure is a failure in which nothing is learned.
At any rate, I suspect that this will become a pivot point for evaluating staffing effectiveness, so we might as well embrace the notion that effective data analysis takes the guesswork out of improvement opportunities. And the less we guess, the more solid the foundation upon which we build our strategies Give me a “D,” give an “A,” give me a “T,” give me another “A!”
About the Author: Steve MacArthur is a safety consultant with The Chartis Group. He brings more than 30 years of healthcare management and consulting experience to his work with hospitals, physician offices, and ambulatory care facilities across the country. He is the author of HCPro's Hospital Safety Director's Handbook and is an advisory board member for Accreditation and Quality Compliance Center. Contact Steve at stevemacsafetyspace@gmail.com.