Using patient acuity data to manage patient care outcomes and patient care costs.

This article describes actual reported uses for patient acuity data that go beyond historical uses in determining staffing allocations. These expanded uses include managing patient care outcomes and health care costs. The article offers the patient care executive examples of how objective, valid, and reliable data are used to drive approaches to effectively influence decision making in an increasingly competitive health care environment.

Developing staffing standards. Statistical considerations for patient care administrators.

To demonstrate accountability and responsibility for patient care operations, patient care leaders are re-evaluating staffing standards. Typically, activity studies are conducted and statistical methods correlate patient acuity levels to hours per patient day (HPPD). The authors discuss statistical considerations that allow patient care leaders to evaluate the appropriateness of HPPD generated by activity study data.

Improving productivity: a payer/provider debate.

In the world of healthcare, there is a great deal of passion about productivity. Even mention of the word sparks internal angst and intense discussion--among providers and payers alike. Creating dialogue about productivity and its merits was the motivating force behind a debate at the American Organization of Nurse Executives 31st Annual Meeting in San Diego, California. Payer and provider representatives were given an opportunity to define and elaborate key factors that drive or inhibit productivity and core issues related to an important coexisting variable, that is, quality. The debate was moderated by Ann Van Slyck, MSN, RN, CNAA, FAAN, President of Van Slyck & Associates, Inc., of Phoenix, Arizona.

Variable billing for services: new fiscal direction for nursing.

The advantages of variable billing for nursing care that: It identifies revenue nursing cost centers. It facilitates systematic control of revenue and expenses, improving budget planning and management. It generates a tremendous amount of data that can be used in administrative planning and decision making. It is more equitable than past billing practices for the patient, the third-party payer, and the hospital, making it a public relations asset. The disadvantages of variable billing are that: Charges at one hospital are not easily compared with those at another. The mix of patients at varying classification levels has a significant effect on revenue, thus increasing the possibility of lower revenue. More accountability and in some cases more work is required of nursing administrators. In this article, the practical application of variable billing in acute care settings has been discussed. It is hoped that the information provided here will stimulate nursing administrators to assess the feasibility of implementing varible billing for nursing services as a fiscal practice in their own institutions.