Workload and short sickness absences in a cohort of Finnish hospital employees

This article used register data on day-to-day working hours of hospital employees combined with patient characteristics at work unit (wards) level to measure workload and its implications for short, self-certified sickness absences. We measured statistically the average nursing treatment burden of different patient mixes in hospital wards, and then analyzed the overall workload (intensity) of working days by comparing it to the actual available nursing workforce. We found that a significant part of the workload variation occurred between working days, and it was related to unexpected changes in the number of employees. In atypical situations a long work shift was associated with caring for patients with fewer resources. The high workload of a day increased the risk of short sickness absences along the following 3-week period. The results show that managing short-term workload variability should be a key aim from the perspective of well-being at work, and that combining different data sources can provide novel, important insights to the measurement of workload.

Evidence-based human resource management: a study of nurse leaders' resource allocation

AIMS

The aims were to illustrate how the RAFAELA system can be used to facilitate evidence-based human resource management.

BACKGROUND

The theoretical framework of the RAFAELA system is based on a holistic view of humankind and a view of leadership founded on human resource management.

METHODS

Nine wards from three central hospitals in Finland participated in the study. The data, stemming from 2006-2007, were taken from the critical indicators (ward-related and nursing intensity information) for national benchmarking used in the RAFAELA system. The data were analysed descriptively.

RESULTS

The daily nursing resources per classified patient ratio is a more specific method of measurement than the nurse-to-patient ratio. For four wards, the nursing intensity per nurse surpassed the optimal level 34% to 62.2% of days. Resource allocation was clearly improved in that a better balance between patients' care needs and available nursing resources was maintained.

CONCLUSIONS

The RAFAELA system provides a rational, systematic and objective foundation for evidence-based human resource management.

IMPLICATIONS FOR NURSING MANAGEMENT

Data from a systematic use of the RAFAELA system offer objective facts and motives for evidence-based decision making in human resource management, and will therefore enhance the nurse leaders' evidence and scientific based way of working.

Benchmarking in nursing care by the RAFAELA patient classification system - a possibility for nurse managers

AIM

The aim of the study was to explore the possibilities of benchmarking with the RAFAELA system. In this study, comparisons are made between: (1) costs for one nursing care intensity point; (2) the nursing care intensity per nurse; (3) the relationship between nursing care intensity per nurse and (4) the optimal nursing care intensity.

BACKGROUND

During the period from 1994 to 2000 a new system for patient classification, the RAFAELA system, was developed in Finland.

METHODS

86 wards from 14 different hospitals in Finland took part in the study.

RESULTS

The costs for one nursing care intensity point on the adults' wards were on average 7.80euro. The average workload was 25.2 nursing care intensity points per nurse. The optimal nursing care intensity was exceeded during 49.5% of the days and under during 20% of the days.

CONCLUSIONS

The study shows that benchmarking with the RAFAELA system provides many opportunities for the nurse managers' resource allocation and their personnel administration.