Nursefinders Survey Uncovers Perceived Impact of Nurse Staffing Strategies on Patient Care and Revenue/Admissions

Labor management strategies top the list of actions taken to improve productivity at health care facilities

• June 28, 2006
• Arlington, Texas

Nursefinders, Inc. today released the latest findings of its Quarterly Nurse Staffing Survey. The survey is the first of its kind to explore productivity management in terms of the correlation between various types of nurse staffing strategies and their perceived impact on patient care and revenue/admissions. The survey also identifies labor data capture and changes in labor management strategies as the top actions being taken by health care executives to improve productivity. These are just a few of the survey’s major findings.

“Productivity management is the second highest concern to health care executives in 2006, behind inadequate reimbursements,” said Nursefinders CEO Bob Livonius. “Health care executives are being asked to battle the nursing shortage, while improving productivity, and in many cases, increasing capacity to meet the growing number of aged and uninsured patients in America. With labor being hospitals’ single largest expense, this survey sheds light on how executives may be using various staffing solutions to achieve these goals.”

The nurse staffing solutions correlated in this survey with patient care and revenue/admissions are utilization of: full-time/core nurses; internal flex/float/part-time nurses; per diem agency nurses; travel agency nurses; and overtime pay.

Overtime Ranked Lowest in Positive Impact on Patient Care and Revenue/Admissions, yet Second Most Utilized Staffing Solution

According to the Nursefinders survey, more than one-quarter (28%) of facilities reported increased overtime utilization for 1Q 2006, as compared to 4Q 2005. This makes overtime the second most frequently used staffing solution after full-time/core nurses (36%). 

In addition to commonly being thought of as a costly expenditure, overtime was also ranked by respondents as the least effective when it comes to positively impacting patient care and revenue/admissions. Therefore, it is an unexpected finding that overtime ranked so high in utilization. 

Increases in Nurse Labor Usage

1. Full-time/Core (36%)
2. Overtime (28%)
3. Flex/Float/Part-Time (26%)
4. Per Diem Agency (21%)
5. Travel Agency (15%)

Increasing Internal Float, Agency Per Diem and Agency Travel Nurses Perceived to Have Same Impact on Admissions/Revenue

While health care executives believe increasing full-time/core nurses has the greatest impact on increasing admissions/revenues (80%), they view flex/float/part-time, agency per diem and agency travel nurses to be approximately the same when it comes to increasing admissions/revenue at their facility.

Greatest Positive Impact on Revenue/Admissions

1. Full-time/Core (80%)
2. Flex/Float/Part-time (56%)
3. Per Diem Agency (50%)
4. Travel Agency (50%)
5. Overtime (33%)

Increasing Utilization of Full-Time/Core Nurses Most Common Staffing Solution and Considered Highly Beneficial

Health care executives are increasing their use of full-time/core nurses more than any other staffing solution, according to the Nursefinders survey. In addition, the clear majority of respondents consider the increased use of full-time/core nurse to have a positive impact on improving patient care (80%) and increasing admissions/revenues (80%).

Internal Float Nurses Have Greatest Positive Impact on Patient Care

According to the Nursefinders survey, health care executives believe increasing flex/float/part-time nursing staff has the greatest positive impact on patient care. Nearly 85% of respondents claim their increased use of flex/float/part-time nurse staff improved patient care at their facility, even more so than increasing full-time/core staff.

Greatest Positive Impact on Patient Care

1. Flex/Float/Part-time (84%)
2. Full-time/Core (80%)
3. Per Diem Agency (60%)
4. Travel Agency (50%)
5. Overtime (37%)

According to Livonius, “Health care executives certainly view additional full-time nurses as a win-win in terms of patient care and admissions, but they also seem to recognize the inherent value of “floating” resources, many of whom are cross-trained and able to be assigned to the department in which they’re most needed. This is similar to the value derived from per diem agency nurses, when strategically utilized. For many of our large customers, the question becomes a matter of who can better recruit and administratively manage flexible nurse resources.”

“Among all of the staffing options, however, overtime is not only costly but also ranked as least effective in terms of increasing patient care and admissions/revenues. This may imply recognition by health care executives of the ‘burn-out’ factor and risks that come with over-utilization of overtime. When it comes to productivity management, overtime appears to be an additional area for improvement.”

Health care Executives Identify Actions Planned, or Taken, to Improve Productivity

The following actions were identified by a panel of health care executives as actions that have been taken or are planned for their facility.

Productivity Improvement Actions (by ranking)

	Action	% age responding “yes”
1.	Capturing data on total labor costs and utilization	78%
2.	Investing in new software or technology systems	69%
3.	Exploring new nurse staffing strategies (i.e. vendor management solutions, expanding float/flex/part-time resources, outsourcing management of supplemental nurse resources)	60%
4.	Altering employee wages and benefits	46%
5.	Adjusting nurse/patient ratios	45%
6.	Hiring a business consultant	16%

“When it comes to a facility’s nursing staff, the key to success in today’s health care environment is about more than simply filling shifts with a warm body,” said Livonius. “It’s about exploring new staffing strategies that apply metrics to track and report staffing effectiveness, streamline internal processes and improve the supply of qualified health care staff while assuring the highest quality patient outcomes.”

The Nursefinders, Inc. Quarterly Nurse Staffing Survey is conducted with a panel of health care executives (115 respondents), each representing unique health care facilities which vary in revenue size and number of beds, including hospitals, long-term acute care and others, from across the country.