Auckland DHBs slower off mark with safe staffing tools

1 September 2012
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Better patient workload prediction and improved rostering of staff to match can help meet the challenging demands of the modern health care system, says Jane O’Malley, Ministry of Health Chief Nurse.

O’Malley said she could not comment on board funding, but anywhere in the health system, there were times when the amount of work to be done outstripped the staff available to do it.

She said one response was the Safe Staffing Health Workplace (SSHW) unit’s development of electronic care capacity demand management (CCDM) tools, which (along with releasing time to care projects) “can at least ameliorate what is undoubtedly an incredible amount of work to be done”.

“Adopting an approach where you can more rationally predict the amount of work to be done and the type of person to do it – whether it be a health care assistant, EN, or RN – and roster that ahead of time, you are more likely to have a more manageable workload most of the time,” said O’Malley.

To introduce the CCDM tools, DHBs must have TrendCare (which currently about 12 DHBs have invested in) or a similar electronic patient acuity/workload management system that can help objectively measure nursing workload.

Waitemata now has TrendCare in place in an initial 20 wards, including two mental health units, and working with the SSHW unit on the first stages of rolling out the CCDM tools.

Peach said she anticipated the CCDM programme would help the DHB understand its demand and capacity issues, but it was not a quick fix and would take at least 12 months to roll out across three areas. Last month, the DHB launched the CCDM questionnaire to get feedback from all staff (not just nurses) on how they perceive their workload.

Dotchin said she hoped within a couple of months to put a business case to the DHB board for purchasing TrendCare – the move follows a presentation by the SSHW unit in early July about its work and the CCDM tools. The presentation arose from a bipartite union DHB advisory group meeting and Dotchin had made a commitment for NZNO delegates to be involved in preparing the business case, including proposing which areas TrendCare and the CCDM tools should be piloted in first.

“Patient safety, quality of care, and staff welfare are of utmost importance to me, and I believe working collaboratively with the union will assist us in meeting those goals,” Dotchin said.

Kivell said Counties Manukau was in the early scoping stages of considering a business case for purchasing a validated electronic acuity tool like TrendCare.

She said it did have capacity planning tools to look at daily workload resources and incoming patient demand and an escalation plan when extra staffing is required.

“I don’t doubt it would be useful to have a validated acuity tool as well,” Kivell said.