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Have hospitals always compiled staffing plans and reports?

Yes, hospitals have always compiled staffing plans and reports. Under PatientCareLink these plans and reports are being developed in a uniform way so the public can see the different factors that go into the development of a plan.


How are staffing plans and reports determined?

Staffing plans and reports are determined based on patients needs. The nurse manager together with other staff develops the plan based on the anticipated needs of the patients who will be assigned to the unit. The plans and reports need to be flexible to account for changes that occur. Patients' needs change over the course of a day and staffing is adjusted to account for those changes. Every patient needs the right care, not the same care. 


Are staffing plans and reports only for nurses?

Staffing plans and reports involve the team of professionals who may be involved in the care of a particular patient and are based on the patient's individual clinical needs. Nursing plays an important role in the care of every patient but nurses are just one part of a larger team of caregivers who work together to make sure that patients receive the highest quality of care. 


Why do some hospital staffing plans and reports list licensed practical nurses (LPNs) separately and others group them with registered nurses (RNs)?

In those hospitals with only a few LPNs on staff, it is difficult to predict when they will be working. These hospitals have included the LPN numbers into the overall licensed staff numbers, which include both RNs and LPNs. 


Can any conclusion be drawn if the staffing on one unit is higher or lower than another?

Direct comparisons like that cannot be made between or across units. Staffing is based on the needs of a particular patient unit and can differ from unit to unit within the same hospital. For example, staffing in an intensive care unit is higher than staffing in a general medical surgical unit because of the critical needs of patients that are in intensive care units. They require more hours of nursing care and close monitoring for changes in condition. Staffing across similar units can also vary based on the experience and education of the registered nurses and the availability of other clinical caregivers, such as therapists. When looking at a staffing plan, it is important to look at the indirect resources that also provide care, and to look at other attributes of the unit, such as technicians or specialists who may provide care and services.


Why do staffing numbers differ from hospital to hospital and unit to unit?

Staffing numbers vary because patient care needs differ and can change minute- to-minute, hour-to-hour. Staffing has to be closely watched and adjusted from based on the changing needs of the patients.
The plan is based on averages. There are times when more staff will be needed and times less staff will be needed.
Activity on a patient care unit changes constantly and, therefore, patient needs change constantly. For example, admissions, transfers and discharges occur on a regular basis, changing the make-up of a unit, and patients may become sicker during a day and need more nursing care than previously expected.
Nurse staffing is frequently evaluated and readjusted to make sure patients are properly cared for. The staffing plans and reports, therefore, are not meant to compare one hospital to another or one unit to another, but are a planned baseline from which patient care needs are adjusted. 


Why is a particular inpatient medical and/or surgical unit in a hospital missing?

Some units may not be posted on the website. For example, units that have opened since the posting of the plans and reports are not included.


Why are some units missing, such as obstetrical, and post anesthesia care?

We began with inpatient medical, surgical, intensive care, rehabilitation, behavioral health and skilled nursing care units first.  We later added emergency departments, and we are exploring the feasibility of adding other units in the future.


Why does it seem there are fewer staff on the evening and night shifts?

On some units, there is fewer admissions, transfers and discharges on the later shifts. Also, during the evening and night, patients may receive fewer treatments, tests and transporting, and may have fewer needs for assistance with daily activities, such as bathing or eating. However, some units have the same number of RN staff on all shifts, such as intensive care units (ICUs) where the care needs are less varied. 


How frequently will the staffing plans and reports be updated?

At the hospital level, these plans are constantly changing depending upon the needs of the patients on a particular unit. On an annual basis, this website will be updated to include the next year's staffing plans and the prior year's staffing reports. The staffing reports will also include information about why the staffing delivered on a given unit may be different from the plan.