Applying the workload indicators of staffing needs method in nursing health workforce planning: evidences from four hospitals in Vietnam.

BACKGROUND: Vietnam has encountered difficulties in ensuring an adequate and equitable distribution of health workforce. The traditional staffing norms stated in the Circular 08/TT-BYT issued in 2007 based solely on population or institutional size and do not adequately take into consideration the variations of need such as population density, mortality and morbidity patterns. To address this problem, more rigorous approaches are needed to determine the number of personnel in health facilities. One such approach is Workload Indicators of Staffing Need (WISN) developed by the World Health Organization (WHO), a facility-based workforce planning method that assists managers in defining the responsibilities of different workforce categories and improving the appropriateness and efficiency of a staff mix. METHODS: This study applied the WISN approach and was employed in 22 clinical departments at four hospitals in Vietnam between 2015 and 2018. 22 targeted group discussions involving nurses were conducted. Hospital personnel records have been retrieved. The data were analyzed according to WISN instructions. RESULTS: Of the 22 departments, there was a shortage of 1 to 2 nurses in 10 departments, with WISN ratios ranging between 0.88 and 0.95. Only 01 clinical colleges at Can Tho Hospital lacked 05 nurses, facing a high workload with a WISN ratio of 0.78. Administrative time represented 20-40% of the total work time of a nurse. In comparison, nurses at Can Tho Hospital spent time on administration from 24 onwards. 5-41.7% of their working time while nurses at Thanh Hoa Hospital spent 21-33%. CONCLUSIONS: The application of the WISN enabled health managers to analyze the workload of nurses, calculate staffing needs, and thus effectively contribute to the workforce planning process. It is expected that the results of this research will encourage the use of the WISN tool in other hospitals and health facilities across the health system. At provincial and national levels, this study provides important evidence to help policy makers develop guidelines for personnel norms for health facilities in the context of limited resources, while the existing regulation is no longer appropriate.

Level and Influencing Factors of Job Motivation Among Administrative Staff at Public Hospitals in Vietnam.

Administrative staff at healthcare facilities, who are not either doctors or nurses, coordinate, facilitate patient care, and account for 18-20% of human resources in hospitals. Their contribution to the value chain of healthcare service is crucial, but they are not well recognized either by hospital managers and healthcare staff or by patients. Low recognition may cause low job motivation and repeated tasks may cause boredom for them. Our study aimed to assess the level of job motivation among administrative staff in 2 hospitals of Ho Chi Minh city, Vietnam, and explore the influencing factors to job motivation. The exploratory mixed methods design was used in our study with an initial quantitative study with a designed questionnaire and then followed by a qualitative study with focus group discussions. The job motivation index of the administrative staff in our study was not high (4.0). Positive factors were extra income, higher education, healthcare benefits, and a good working environment. Negative factors were low salary index, less chance of higher education, and no separated key performance indicator criteria. The low job motivation index of the administrative staff at public hospitals in our study warns of the negative impact on hospital income in terms of patient satisfaction. In the future, hospitals should have a new strategy in human resource management specifically for administrative staff by maintaining the positive factors and step-by-step overcome the negative factors such as developing separated key performance indicator criteria.