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Going Beyond Patient Classification Systems to Create an Evidence-Based Staffing Methodology

Fasoli, DiJon R. PhD, RN; Fincke, Benjamin G. MD; Haddock, Kathlyn Sue PhD, RN

JONA: The Journal of Nursing Administration: October 2011 - Volume 41 - Issue 10 - p 434-439
doi: 10.1097/NNA.0b013e31822edd8e

The Department of Veterans Affairs developed a nationally standardized nurse staffing methodology, using an evidence-based process. We present an overview, linking an integrative review of recent literature on patient classification systems, interdisciplinary expert panel consultation, operational feasibility assessment, and frontline manager involvement. This resulted in 7 candidate indicators for inclusion in unit-specific staffing models. Adaptable to all healthcare settings, this process goes beyond traditional patient classification systems.

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Author Affiliations: Research Health Scientist (Dr Fasoli) and Senior Research Health Scientist (Dr Fincke), Center for Health Quality, Outcomes and Economic Research, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, Massachusetts; Associate Professor of Public Health (Dr Fincke) and Research Instructor (Dr Fasoli), School of Public Health, Boston University, Massachusetts; and Associate Chief of Staff for Research (Dr Haddock), Wm. Jennings Bryan Dorn VA Medical Center, Columbia, South Carolina.

Funding: This material is based on work supported by the Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, Health Services Research and Development (RRP 07-336: Assessing Evidence for Nurse Staffing to Improve Patient/Organizational Outcomes, Haddock, 2007).

Disclaimer: The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the US government.

The authors declare no conflict of interest.

Correspondence: Dr Fasoli, Department of Veterans Affairs, Edith Nourse Rogers Memorial Veterans Hospital (152), Bldg 70, 200 Springs Rd, Bedford, MA 01730 (;

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© 2011 Lippincott Williams & Wilkins, Inc.