Cost and performance issues: rural nurse managers needed for nursing labor costs and hours research.

The researcher is currently involved in nursing labor research with Nurse Managers (NMs) in two rural hospitals, one in Colorado and the other in Alabama. The usefulness of computer software that tracks nursing labor data on a daily basis in the different departments in a rural hospital is being studied.

As her dissertation research, the researcher developed a Labor Computer Decision Support System (CDSS) to assist nurse managers to use daily labor productivity data in making nursing labor decisions. The benefits of the system were tested in two large urban hospitals. The benefits of the labor CDSS led to implementation of the system on all 22 nursing units in one of these hospitals.

In addition to being able to measure and control nursing labor costs, NMs identified numerous benefits of using the labor CDSS. The most frequently reported benefit was decreased bookkeeping time and an easy to use tool. Other benefits included clear, definable actual versus budgeted labor cost data through spreadsheet applications. Pay period ending dollar and hour projections were provided for each unit on a daily basis. This daily projection allowed staffing adjustment decisions to be made to better conform to the budgeted dollar and hour figures.

A permanent record of labor hours and cost data was also provided. The nurse managers established a labor productivity measurement notebook with hard copies of their historical Pay Period Ending results. The CPMT provided a means to analyze future changes and their implications for labor cost on the unit. Nurse managers performed "what if" analysis to determine the effects of staffing changes or pay raises on the financial performance of the unit.

Another benefit noted was the CPMT replaced a time consuming and often erroneous manual productivity tracking system. The graphs and charts for visual display of productivity measurement data were also noted as a benefit. The percent labor hours by category and the census variation charts were reported by the NMs to be the most helpful in managing labor costs on their units.

Additional benefits from use of the CPMT were reported by the Chief Nurse Executives. Because daily access to departmental labor productivity measurement data was available, staffing changes were encouraged on units that were over their nursing labor budget or under or over utilizing their nursing staff. Daily reports of the nursing labor costs and hours for the entire hospital were available for meetings with other managers.

Since the tool also provided Year to Date (YTD) data, the nurse managers found the tool to be very beneficial in budgeting for the next year. Each pay period of the year could be reviewed separately and total yearly data, such as total census in each department and costs were displayed.

The researcher is seeking additional rural nurse managers to participate in a large study in the fall or winter of 2001. The computer software would be provided for the nurse managers to use to track nursing labor data to determine the usefulness of the software. The researcher is also very interested in developing a Web site to provide benchmark data to hospitals using the system.

If you are interested in participating in this research please contact the researcher at [e-mail] or by phone [phone].

To hear more about this project, attend the RNO meeting in Estes Park, Colorado September 14-15, 2001. For conference information contact Centennial AHEC at 970330-3608 or visit the website for registration materials at www.cahec.org.

Melondie Carter, DSN, RN

Editorial Board Member