Spaulding Hospital for Continuing Medical Care Cambridge - 4 West

Long Term Acute Care
4 West
Adult Medical
Variance Info
Current Posted Planned Worked Hours Per Patient Day 8.00
Actual Worked Hours Per Patient Day 9.21
Variance 1.21
% Variance from Budget 15.13%
 
Reason For +/- 5% Variance From Budget
No explanation required  
Fluctuating day to day census X
Lower daily census than planned  
Higher daily census than planned  
Higher patient care needs than planned X
Lower patient care needs than planned  
Staff vacancies X
Adjusted for patient care needs X
Minimum fixed staffing requirements  
Care delivery model changes  
Increased 1:1 staffing requirements X
Closure of unit  
Not admitting to beds due to staffing  
Increased census to telemetry patients  
Plan based on high needs in critical care  
Increased staff hours to facilitate admissions and discharges  
Change in patient mix X
 
Other Reasons for +/- 5% Variance
SHC utilizes the Quadramed acuity system to determine nursing workload and adjust staffing to meet patient's changing needs. 4 WEST has seen an increase in the complex neurological and disorders of consciousness patient population which required and increase in the staffing grids. An increase in patient's requiring 1:1 observation to prevent the removal of medical devices and also to manage their agitation required an increase in CNA's. Orientation costs for 4 WEST were also above budget for this year due to staff turnover.
 
Additional Comments

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