A Model for Achieving Staffing Excellence
The model below embodies the concepts and principles represented in the definition and standards for excellence in staffing, and demonstrates an integration of the various elements explored in this paper.
Elements of the Staffing Model
As represented in the staffing model, the following core elements are essential components of an evidenced-based staffing framework and interact with one another to support the definition and standards of excellence.
Patients
As used in the model, the term “patients” refers to individuals receiving care, as well as family members and other loved ones who require the teaching and support of nurses and other direct care providers. The Model for Achieving Staffing Excellence purposely places the patient both within and outside the care environment and illustrates how all patients bring into the care environment their own set of values, beliefs, expectations and needs — a dimension that is often overlooked, but that is needed to inform excellent staffing decisions.
Nurses / Care Team
By definition, staffing involves the matching of patients with nurses and other licensed and unlicensed staff who care for them. The model incorporates nurses and other care providers, as well as the role and skill competencies and experiences they bring to the care equation. The model also acknowledges the values and beliefs of caregivers, and how these influence caregivers’ lives and experiences within and outside the care environment. A professional practice model that promotes role-appropriate autonomy and accountability is implied.
Needs / Competencies
Aligning role competencies and related skill competencies to the specific and changing needs of patients is the art and science of staffing. Placing competencies and needs at the intersection of the patient and care team highlights the importance of this information to staffing decisions.
On-going Evaluation and Feedback System
It is through careful and on-going monitoring that positive impact is recognized and issues are identified and addressed. Data about each element of the staffing model combine to inform clinical, quality, and financial outcomes for patients, the workforce and the organization and are used to drive changes in staffing practices.
Evidence / Science
The use of evidence and science to inform excellence holds a foundational position in the model. Its placement speaks to the way evidence must influence all aspects of staffing. New knowledge about staffing practices and their impact keeps the staffing program in a state of dynamic evolution and informs continual improvement.
The Care Environment
In the model, the environment represents any physical location in which care is delivered, and includes the organization’s purpose, culture, and systems. Its location in the model acknowledges the environment as the place where patients and the care team intersect. The model also recognizes internal and external influences that impact the care environment and their changing nature.
External Influences
Many external influences come to bear on the patient, workforce, and care environment. This highlights the complex and interconnected nature of the external and internal environments in which care is delivered.
