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Weighted Staffing Plans for Better Prediction of Staffing Needs

Tierney, Shirley J. PhD, RN; Seymour-Route, Paulette PhD, RN; Crawford, Sybil PhD

Journal of Nursing Administration:
doi: 10.1097/NNA.0b013e3182a23e41

OBJECTIVE: The aim of this study was to examine the effect of patient turnover and acuity on worked hours per patient day (WHPPD).

BACKGROUND: An examination of staffing plans publically posted by Massachusetts hospitals with more than 300 beds revealed that less than 40% were within 5% of their planned versus actual WHPPD.

METHODS: Three years of WHPPD data collected from 14 adult acute care units were correlated with patient turnover and acuity data. A weight factor was retrospectively added to 8 paired units’ planned WHPPD where correlations were identified.

RESULTS: Twelve units (86%) showed significant correlations between WHPPD and patient turnover. Correlations between patient acuity and WHPPD were significant only at the aggregate level. After weighting WHPPD, the 8 paired units demonstrated a decreased variance between planned and actual WHPPD.

CONCLUSION: Using a weight factor added to WHPPD to right size acute care medical-surgical units may be useful for accurate staff planning and budgeting.

Author Information

Author Affiliations: Director of Nursing Informatics (Dr Tierney), UMass Memorial Medical Center; Dean (Dr Seymour-Route), Graduate School of Nursing, University of Massachusetts; Associate Professor (Dr Crawford), Department of Medicine, Medical School, University of Massachusetts, Worcester.

The authors declare no conflicts of interest.

Correspondence: Dr Tierney, UMass Memorial Medical Center, University Campus Room HB-311, 55 Lake Ave North, Worcester, MA 01655 (

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins