Staffing Matrix and Reflection Discussion
A staffing matrix is a technique used by health facilities to assess the number of staff needed in each level for smooth operations. This tool evaluates the staffing needs of each group/ department and makes adjustments as necessary. Nursing plays a critical role in the determination of the quality of care provided by nurses as well as patient outcomes. Based on this analogy, it is paramount for health facilities to effectively schedule and plan for their staffing needs to offer reliable, safe, and quality care to patients.
Importance of a Staffing Matrix in a Health Care Setting
As the lead nurse of the facility, I use a staffing matrix to maintain the provision of high-quality services to patients. The staffing matrix helps me to create an effective work plan that allocates adequate staff to all departments of the facility based on prevailing demand. Some levels in the facility often require more attention than others, using a staffing matrix, I can allocate each department adequate employees that match their workload. The allocation of staffing needs to each department is made with strict observance of finances.
The staffing matrix is critical in eliminating costly mistakes caused by stress, pressure, and fatigue by nurses (Trepanier et al., 2017). Using the staffing matrix, I create effective work schedules for the staff such that all nurses work in shifts to avoid exhaustion. Through the staffing matrix, I have developed a shift strategy that ensures nurses are not overworked and at the same time there is no staffing deficiency in any department/level. When nurses work long hours, they become stressed and fatigued. The chances of making medical errors under stress or fatigue is very high. The staffing matrix aims to create a work schedule that eliminates fatigue in nurses due to working long hours.
I use a staffing matrix to create the shift of budget to actual dollar variation from unfavorable/losses to favorable/profits. This strategy prevents money from getting lost from issues such as patient falls, and workers compensation claims arising from sprains or strains. Besides, the staffing matrix is critical in dealing with the issue of no meal-break or no-rest which impacts the performance of nurses. Using this technique, all nurses got their scheduled breaks and rests. This factor is important because if not treated with care, nurses may start to experience fatigue that may jeopardize the provision of quality care.
A Description of my Staffing Matrix
The surgical facility requires a minimum of 8RN nurses at any time day or night. This is because the facility experiences a heavy patient census during the day more than night time. Concerning the measure of success, the staffing matrix that I employed used 11 RN nurses and 3 assistants during the day and 10 nurses and 3 assistants for the night shift. The shifts of all assistant nurses were capped at a maximum of 12-hour shifts with scheduled breaks throughout the shift.
In developing the staff matrix, I engaged the use of financial management principles for efficiency. The financial management principles I used include timeliness, consistency, Justification, and documentation (Olley et al., 2019). Concerning consistency, I ensured that the procedures and the policies on staffing are appropriately established and conducted in a consistent manner. For timeliness, all transactions on staffing are carried out in a timely way taking into consideration timeframes. Regarding justification, a valid reason for each transaction is provided. Lastly, all transactions were documented to show proof of all transactions.
Adjustment on Staffing Based on Changes in the Patient Census
My staffing matrix is created contingent upon patient census. I have as mentioned earlier, 11 nurses during the day and 10 nurses during the night was the formula I use in my matrix. Additionally, I have allocated three assistant nurses both for day and night shifts to help the full-time nurses. Besides, I have 4 on-call nurses for the day shift and 3 for the night shift that I call when patient traffic at the hospital increases. Additionally, the night and day shifts both have a relief nurse and a charge nurse on duty.
During the low census, I adjust the assignments of the FBC nurse depending on the needs of the facility. Some RN nurses may be shifted to other departments or other projects such as personal education development, cross-training, or other projects within the facility. The need for RN nurses in all departments is critical, however, RN nurses are allocated according to the needs of each group. Being a surgical facility, most RN nurses will be allocated to the surgery department and a few to the general department. However, more RN nurses may be assigned to the general unit during a low patient census in the surgical department.
Making Up for the Variance
The discovery that I have used more FTEs than budgeted for is likely to create accounting problems considering the budget constraints. As the nurse leader, there are a few techniques available to me to make up for the variance while still complying with set regulations. One method that I will use to balance the variance is to reduce the number of hours per shift for all FTEs during the night shift and day shift. Instead of the 12-hour shift, the FTEs will only do a maximum of 9-hour shifts for the month. Every shift will still have at least 8 RNs in the surgical department.
The number of assistant nurses remains as it was before-3 for both night and day shifts. Alternatively, I can increase the use of part-time nurses while reducing the number of FTEs. The idea here is to curb the ballooning wage of FTEs by capping their numbers per shift and the number of hours they work per shift until the variance is balanced.
A staffing matrix is a technique used by health facilities to evaluate the staffing needs of each group/ department and make adjustments as necessary. The staffing matrix has numerous advantages such as eliminating mistakes caused by stress, pressure, and fatigue by nurses. Health facilities can use effective work schedules for the staff such that all nurses work in shifts to avoid exhaustion. The staffing matrix helps health facilities to maintain the provision of high-quality services to patients.
The staffing matrix helps me to create an effective work plan that allocates adequate staff to all departments of the facility based on prevailing demand. In low census, I adjust the assignments of the FBC nurse depending on the needs of the facility. Some RN nurses may be shifted to other departments or other projects such as personal education development, cross-training, or other projects within the facility.
- Nguyen, A. (2015). Acuity-based staffing. Nursing Management, 46(1), 35-39. doi: 10.1097/01.numa.0000459555.94452.e2
- Olley, R., Edwards, I., Avery, M., & Cooper, H. (2019). Systematic review of the evidence related to mandated nurse staffing ratios in acute hospitals. Australian Health Review, 43(3), 288. doi: 10.1071/ah16252
- Trepanier, S., Lee, D. W., & Kerfoot, K. M. (2017). Interoperable acuity-based staffing solutions: lessons learned from a multi-hospital system. Nursing Economics, 35(4), 184. doi: 10.1181/bh16252