Introduction
Staffing in hospitals and healthcare systems is complex, increasingly regulated, and closely associated with patient safety. Moreover, a growing body of evidence suggests that quality, cost of care, safety, length of stay, readmissions, patient, physician and staff satisfaction, turnover and vacancy rates — all of which have an impact on operational and financial performance — are linked to staffing. Consequently, healthcare administrators are under pressure from insurers, patient advocates, unions, and state and national governments to define, secure and assure effective, safe, cost-effective staffing. This mandate is complicated by falling reimbursement rates, increasing labor shortages, rising labor costs, and increasing patient acuity.
An issue that affects an organization so pervasively, cries out for definition. So this quest began by asking “What is excellent staffing?” And then, “How do we know when we’ve achieved it?” Investigation into these questions generated a lot of interest, but few answers. Thus the decision to convene an invitational conference that would bring a broad spectrum of operational and ‘thought’ leaders together, and ask them to address these questions directly. This led to a remarkable gathering that included thought leaders from a wide range of backgrounds (see list of contributors Appendix A) who donated their time and insights to answering these questions (see Appendix B for the process used). This paper is one outcome of that gathering. It is not a definitive statement, so much as it is an opening gambit in an ongoing discussion which, it is our hope, will eventually lead to consensus on an operational definition of excellence in staffing.
