Why We Should Be Paying Attention to the Evolving World Of Staffing Technology Solutions.

Staffing solutions are evolving at remarkable speed. It no longer takes large, complicated, technical teams to create powerful, reliable, high-quality solutions. Today's cloud-based solutions can be implemented in hours and configured as fast as an organization can tolerate. These new, well-designed systems are highly intuitive and adopted rapidly. Data can be displayed in different ways for different users with different responsibilities. Upgrades are no longer big, costly events; they are done automatically. Large outlays for licensing fees and big start-up costs are also things of the past.

We can do better.

We should not expect a new model or a brilliant new study to transform staffing in health care from hard to easy. Nurses can't change the complexity of our work; however, we can and must improve the art and science of staffing. e have not mastered the translation of evidence on staffing to influencing budgets, adjusting policies, procedures, and changing cultures as rapidly as we need. esearch has helped in countless ways, but we need more and there is still much to understand. ccurate data collection and a willingness to share that data with researchers will help advance the science of staffing. The road ahead is not easy and will take courage, tenacity, and a lot of energy.

Navajo nation public health nurses inspire thoughts on health care reform.

The wisdom and experience of pubic health nurses serving on a Navajo Reservation, who work far from the typical hospital setting, may well hold some of the keys to how we can successfully plan for and navigate the future of our shifting health care system. As more of the nursing workforce moves outside the walls of the hospital, competencies in autonomy, clinical judgment, decision making, and communication will increase in importance. long with safety and quality implications, this may also influence changes in nursing education, job requirements, hiring, and measuring performance. In addition, there may be implications around how new nurses are oriented and how they get the experience needed to function in more independent roles. Within their routine days, the conditions they work in, the situations they face, and the many ways public health nurses find to meet the needs of the people they serve, is a wealth of knowledge that may well translate into solutions for some of the challenges our nation's health care system is facing.

Staffing for end of life: challenges and opportunities.

What would staffing look like if we committed to end-of-life experiences that were designed to honor the needs of the person dying, their loved ones, and the needs of the nurses and care team involved in the dying experience? When we think about the experience of death in a health care setting, it is essential we look at the needs of both patients and caregivers. Attending to the needs of patients and their families facing death, even if well defined, can be difficult to design into staffing plans and budgets in a way that would not put an organization at further financial risk. If we are going to commit to staffing practices that honor dying, in all it's dimensions and for all who are potentially impacted, we will most likely have to step outside traditional thinking to find answers.

The return of the smiley face.

The iconic, ubiquitous smiley face of the 1960s and 70s represented happiness that could be taken in and felt deeply, even if only for a moment. Today we are in a much different world, one in which the understanding of the value of happiness can seem distant. Talking about "feelings" does not go over well in the board room, in setting workforce management strategies, or in budget discussions. That could all be changing and we may finally be getting the attention of leadership on this long neglected and important topic. The cost and quality implications of an unhappy workforce seem immense. We can keep trying to squeeze more out of our health care workforce or we can invest in their wellbeing and get more out of them.

Through the eyes of gratitude.

There are complex considerations at play when deciding what nurse should work with which patient. During the course of a relationship between a patient and a nurse, or a nurse and a patient's family, remarkable and life-changing interactions can occur. The relationship between Patrick Barnes, his family, and the nurses who cared for them, was the inspiration for the creation of the DAISY Foundation. The DAISY Award focuses attention on the specific behaviors administrators want to encourage to bring the organization's vision and values to life. DAISY stories, presented publicly, uplift all who hear them. We can all learn a lot from the Barnes family story by remembering the power of compassion, the power of gratitude, and the power of recognition.

When caring stops, staffing doesn't matter: part II.

Response to a column on caring and staffing struck a cord with Nursing Economic$ readers worldwide. Measuring caring is complicated and a healthy debate exists over how exactly to do it. The extraordinary work of Dr. Jean Watson is an excellent resource for understanding how to measure and monitor caring. Beneath the instruments for measuring caring sits foundational work that can help us clarify and understand the topic of caring and just where it sits in our philosophies, intentions, patient care models, and care delivery systems.

'The environment matters' and 'designing toward the whole'.

A nurse/health care executive/architecture specialist and an artist/designer offer insights to creating environments that effectively support the delivery of care, the wellbeing of patients and their families, and the well-being of the health care workforce. The care environment is more than bricks, mortar, doors, windows, walls, and flooring. It is a sanctuary where healing can take place, where the spirit can be released, and where the provision of care, often fairly intimate, can happen through the connection between patient and care providers. Evidence-based design has brought forth the kind of inquiry and solutions that begin to address what an environment for healing requires. The interaction of built environment, staff, patients, families, and doctors is an overlapping ebb and flow that relies at its heart on the ability to hold all the parts as having equal priority.

What every nurse executive should know about staffing and scheduling technology initiatives.

Staffing in hospitals has a history of being based in opinion and tradition, not evidence. In recent years, for many, staffing practices have spun out of control creating chaos in overtime, the use of incentives, entitlement behaviors, dissatisfaction and frustration among nurses, and has opened doors for such things as staffing ratio legislation. Unprecedented pressures around budgets and financial performance have no doubt compounded this situation. We are in a new day, where technology can help us more than ever in a move towards staffing excellence and staffing practices based on evidence. Highly successful implementations of new technologies are the result of good leadership. The effectiveness of staffing and scheduling has significant business, safety, and quality implications that sit at the heart of the nurse executive's role.

Ratios--if it were only that easy.

Health care staffing is a complicated arena, and nurses are in the best position to assure a good match between the problems being addressed and the solutions being adopted. Why would nurses want to hand over their power to make staffing decisions to the government? Perhaps what got us into the situation of asking government to intervene in the world of health care staffing is the inability of management and staff to work together effectively to design the most effective approach to staffing. The business side and the quality/safety side of health care must work in harmony. Collaboration between nursing and finance is perhaps the most important formula for success. The challenges before us in health care staffing are big, but they will never be solved by the application of symptom-level solutions.

The human side of staffing.

While the call for data-driven staffing is loud and even overdue, our approach to it must be harmonized with the human side as well. Discovering the right combination of hard data and soft data may well be the impetus needed to catapult a shift in how we approach staffing to new levels of effectiveness. Nurses should not be apologizing for our focus on quality and the patient experience, but rather leveraging the human understanding that nursing has mastered into our business models, financial plans, and staffing programs. The way human beings respond to something, no matter how grounded in scientific facts and evidence, can mean effectiveness or ineffectiveness, success or failure. In developing staffing strategies, programs, and practices, it can be helpful to consider the "experience impact" as part of the decision-making process.

Evidence-based staffing and "communityship" as the key to success.

Embracing an inclusive leadership style is the foundation of building an approach to staffing that maximizes outcomes for patients, the workforce, and the organizations in which care is delivered. By engaging everyone involved and inviting participation, a structure of shared understanding is created, providing an environment that is positioned to achieve optimal results. Communityship offers a model for approaching leadership that is aligned with leveraging talent across an organization and developing a culture prepared to face the complex challenges of staffing and achieving new levels of performance that an evidence-based approach to staffing excellence can offer. A zero-defect health care system can be achieved by developing communityship.

Taking action to close the nursing-finance gap: learning from success.

Nurse leaders control the largest part of a hospital labor budget, in some cases the largest part of the overall budget. The effectiveness of overseeing this responsibility can mean the difference between an organization's financial stability and financial turmoil. The nursing department at Northwestern Memorial Hospital took ownership of its financial performance. Over the past 2 years, their financial performance saved $4.9 million in productivity while reducing nurses turnover costs by $7.6 million. Valuable lessons from their experience are offered for improving health care's financial and operational outlook.

When caring stops, staffing doesn't really matter.

How well do we understand the people side of staffing, and do we recognize the importance therein? Delivering care without caring is simply wrong. Health care leaders must take this concern seriously and find ways to invest in and set up structures that support healthy processing, by individual caregivers, of the many emotional situations that are a natural part of care delivery. Individual care provides must take responsibility for their own well-being and make choices that promote self-care. We must find more ways to recognize and address the needs of care providers who are facing emotional burnout or compassion fatigue, as they are both a threat to their own health and a potential risk to the patients and organizations they serve.