Simplifying Data for Nurse Managers Simplifying Data for Nurse
Contents
1. B z u Eg S06 A V s ga a7 4 SL 2 T im 0 V gg Pe Reply with Changes H Gb Department Name ICU 1 The Greeley Company Date 12 08 03 LVNILPN NT 5 6 5 5 0 1 overstaffed qo 419 360 idm 4o LN E Skill mix Change in census Change in acuity Staff absenteeism m o4 M N Config Data Weekly Summary Day5 4 Day6 4 Day lt Ready Step 3 Selecting interventions Intervention 1 and Intervention 2 In Step 3 you will use the remaining dropdown menu you customized to select either one or two interventions undertaken to solve the under overstaffing problem that occurred in the unit on this particular shift STAFFING ANALYZER SIMPLIFYING DATA FOR NURSE MANAGERS 23 Chapter One Take a look at the screenshot in Figure 1 9 Day 1 screenshot 4 E3 Microsoft Excel RN STAFF V1 5 Arial 8 D c E Su elat ssme 7 E File Edit Yiew Insert Format Tools Data Window Help u fra Pe Reply with Changes E B E H 5 A B 44 o BL Lecetience io Meatihcare Con A Divine at fiche he Greeley Company Department Name Date LVNILPN 12 08 03 NT Variance due to actual 5 B pattern 5 variance 1 understaffed overstaffed Staff absenteeism Reason for Variance intervention 1 Intervention 2 11 00 AM Staff o2. EN sinn Analyzek Simplifying Data for Nurse Managers LAURA HARRINGTON RN CPHQ ADRIANNE E AVILLION DEd RN Contents About the authors ccc ccc ccc ccc ccc ccc cece cc cc ccc ccc ccccccccs Wi Chapter One User manual ccc cccccccccccccccccccsccccccccce Weve i600 bacino E ord Ci wee iro ab eae hae wee el adds VOCE puri Ru sU os d I add 3 Geine Started apes te be s C EXC Ra ase dx TES NX KCN GE EP MU NS a X EM Xx ada 4 What type of computer do I need to use the Staffing Analyzer 0 20000 4 How do I install and open the Staffing Analyzer on my computer susn 4 How do I save a template copy of the Staffing Analyzer on my computer 4 Where is the best place to save the Staffing Analyzer on my computer 4 What is the best method for sharing the Staffing Analyzer with colleagues 5 Enabling sid disabling macros 26254 peokbee dee 3405s bineu eU Rr Ue SES ees 3 Microsoft Excel refresher course vus ee oet REX CR AERE ROEOURR NOR TERR CAO eee eee OR 6 Customizing your Staffing Analyzer resse Data eater a 9A uS ee Sk OOH ee sae eS Ee sS 7 Keys to CUStOMIZING uersu eee Le deo aie ERR e a di a oe add EA 8 Customizing the tool reflect your organization 00cceeccscccsscccceees 10 Customizing your dropdown MENUS sere sre ede Oee OU AR CE EG CER ea b PEN 11 Changing the indicators ead dae x os sev EE he EE UAE EE E CGR RO eA 17 Ent
3. Reasons for variance e Interventions The chart also summarizes the totals mentioned above Variance by staffing type Variance by shifts If you are having trouble finding this chart scroll down to the royal blue section of the day specific worksheet The chart begins on the first row of this section Row 73 and runs down to Row 89 Step 2 Choosing a reason for variance In Step 2 you will use a dropdown menu you customized earlier to select the reason that best explains why there was a variance between your actual and planned data i e Why were you under overstaffed For the purpose of this example assume that your ICU was understaffed by one RN during the 7 a m shift because one of your RNs called in sick Here s how you would use the Staffing Analyzer to show this fact Take a look at the screenshot in Figure 1 8 1 Click on the down arrow in the box on the right side of Cell D10 A dropdown menu will appear 2 Drag your cursor down to the fourth indicator on the list Staff Absenteeism or the indicator that best represents your reason For an explanation of this indicator and the others on the list see Chapter four 3 Left click on this indicator The Staffing Analyzer places your selection in Cell D10 22 STAFFING ANALYZER SIMPLIFYING DATA FOR NURSE MANAGERS User manual Day 1 screenshot 3 E3 Microsoft Excel RN STAFF V1 5 BEE File Edit View Insert Format Tools Data Window Help Arial JB
4. and it will save you a good deal of time when you present your data When your data appears in the graphs discussed later in the Presenting Your Data section it will automatically be stamped with the name of your organization thanks to this first customization step Use the same procedure to change the Department Name in cell A11 from the default ICU to the department for which you will be entering data Again follow the same procedure for entering the Week Beginning date in cell A13 Refer to Figure 1 1 Customizing the tool to reflect your organization We ve already done one customization step for you This appears in the Varience Due To column Column C There are only two indicators to describe the variance between your actual staffing data the number of staff you had working in the department or unit and your pattern staffing data the number of staff you had in your budgetary plan for that department or unit for each staff type on each shift The Staffing Analyzer s two suggested indicators are simply Overstaffed and Understaffed 1 Overstaffed Your actual staffing data is greater than your budgetary staffing plan pattern data 2 Understaffed Your actual staffing data is less than your budgetary staffing plan pattern data 10 STAFFING ANALYZER SIMPLIFYING DATA FOR NURSE MANAGERS User manual If your actual and pattern staffing data are equal the variance is zero you are neither overstaffed no
5. appear in the third yellow column Column L on the Configuring Data worksheet An enlarged copy of the column appears in Figure 1 4 STAFFING ANALYZER SIMPLIFYING DATA FOR NURSE MANAGERS 15 Chapter One These suggested shift starting times can be changed to better reflect the shift changes at your facility In fact they do not need to be designated as a time of day at all You can change the shift times to shift names or simply rename them 1st shift 2nd shift or 3rd shift and so on You do not need to customize or use all five shifts you can use only two or three if that is all your organization typically uses 4 Staffing types The Staffing Analyzer s suggested staffing types appear in the fourth yellow column Column O on the Configuring Data worksheet An enlarged copy of the column appears in Figure 1 5 Staffing types Lut LPH 16 STAFFING ANALYZER SIMPLIFYING DATA FOR NURSE MANAGERS User manual The column includes three suggested staffing types and two blank cells for tracking other staffing types at your organization The suggested acronyms are as follows RN Registered Nurse LVN LPN Licensed Vocational Nurse Licensed Practical Nurse NT Nourse Technician This list may not be an accurate representation of the staff at your facility It is up to you to customize this list to better resemble the staff at your facility You can change any none or all of these suggested staffing ty
6. macros you may need to change your computer s security settings Consult your technology department before you attempt this STAFFING ANALYZER SIMPLIFYING DATA FOR NURSE MANAGERS 5 Chapter One Microsoft Excel refresher course The Staffing Analyzer is a Microsoft Excel workbook An Excel workbook is a file that con tains one or more worksheets Worksheets are your primary documents for storing and working with data Worksheets are sometimes called spreadsheets Each worksheet consists of cells that are organized into columns and rows worksheets are always stored in a workbook Moving between worksheets The Staffing Analyzer is an Excel workbook that features nine worksheets labeled as fol lows ey Configuration Data Weekly Summary Day1 Day2 Day 3 Day4 Day 5 Day 6 9 Day 7 ON AU B UU NM The easiest way for you to move from one worksheet to another is by clicking the sheet tabs at the bottom of the workbook window Each worksheet has its own tab The tab of the active worksheet the worksheet in which you are working is colored white Selecting cells Point and click on the desired cell Moving between cells Y Use the arrow keys to move one cell up down to the right and to the left Y Press the TAB key to move one cell to the right Y Press the RETURN key to move one cell down 6 STAFFING ANALYZER SIMPLIFYING DATA FOR NURSE MANAGERS User manual Microsoft Excel refresher cou
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8. simply a replacement for your paper and pen process for collecting and organizing your staffing data This tool takes it one step further by presenting the results in uncomplicat ed bar charts that can be easily included in any presentation or proposal Each of these full color charts is automatically stamped with your organization s name and the date and can be printed separately in hard copy form or pasted into another computer application in electronic form The daily bar charts which reflect the data you entered for that particular day in that particular depart ment or unit can be viewed at any time by scrolling down each day specific worksheet to Row 91 The bar charts run from Row 91 to Row 332 There are five bar charts on each day specific worksheet They are titled the following 1 Variance due to 2 Variance by shift 3 Variance by staffing type 4 Reason for variance 5 Interventions On all of the bar charts the customized indicators you created on the Configuring Data worksheet appear on the horizontal axis x axis The vertical axis y axis represents the number of times each of the indicators was selected These bar charts also appear on the Weekly Summary worksheet To go to the Weekly Summary work sheet click on the tab titled Weekly Summary at the bottom of the workbook The charts included on the Weekly Summary worksheet reflect all of the data from the bar charts on each of the day speci
9. Data for Nurse Managers Contents Chapter Five Introducing a staffing analysis tool Education and training 69 Planning consdetatOR S oa o dace saca ERS Ea c AE EES OO edid ds 7 The training DEOBEAID 4 241 siu EEG Deae EROR HR Ae eed de dA CE E d A 73 Assessing ongoing training effectiveness cesses etn 74 Training UDOdEQS sss ace died 9b e OR TRE debe ECCE ERE RU UR EU WER dA Rd X SCRCR ES 25 Administrative anvolvemeubt i enziesezxesetee ee ed bae RR EYTR T IS4RRTEC RETE EE 75 Educating staff not responsible for using the tool s 2 924404 eu RE REFER RS ve te 76 Sonnur d P 77 Chapter Six Effective data presentation ee eeee e 79 Common graphic presentations a6 do cece be ERE qn C RERO E eC EXE Rn 82 Bar ehari Jick as E ke eG ee irusta qax WEE TAE Me ENSE tak qalewent ai dap 82 Hist graM sse a ee 84 JUS Dey su ew eas Heed eae eee oe EV CE RENO ROE USE OTe ree es 85 Pinal checklist PERERTETIS TOIT ewe need Pence ete ence ina ere etp ea tee teeteie 86 SUMMA eeni vad oe vad alba w vad oe 4 008 4 ad Sack Deis WOR feu we eS Fae wes Oe cae Bo ewe aR oe 86 Staffing Analyzer Simplifying Data for Nurse Managers 3 CHAPTER ONE USER MANUAL CHAPTER ONE USER MANUAL Overview The increased scrutiny on staffing data collection and its relationship with patient safety has revealed something interesting Although directors of nursing and other clinical services have been collecting staffing da
10. E APR in 42 Capital expenses sS exa Oe dose d OE ex GO EU De CC Rede ca Qo e dC e eoe d OR 42 Operating Gx pense lt caesa eiie oed odes race Vp de be dX a race d ORK REX 42 Personnel expenses cu 2 voce bee RUPEE aeo Ce e Fad CT OR EDI e beth a 43 SUMMALY c PR caddie dba sea dade die ates ee ded bebe Oe Made bie waa oo 44 Chapter Three Identifying and analyzing staffing trends 45 Distinguishing between isolated incidents and trends 00 ce eee eee eee eee tees 47 Geographic competition Tactics aacaa d x RXOCE X Oa ERR CR DE C a aea ee Oe eS 48 Personnel ae Gry 204 eu ete s separe debt ie eee 28h oe bb eK ate id ratem i 49 Health care etvitanment MOIS each oi rg dos hes E EST REPERI PE RE PEERS a Case study Indentifying and analyzing trends 0c cece cece nce eeceesceeveees 54 S mm ryi il dcdwe uee XR DR RE CR gee baa a ORE AURORA E eee OUR RP ROCA aaa ae eed 56 Chapter Four Selecting the best indicators for your organization 57 JCAHO TCU OBS arx Sea C ee he we cC acabe va dog KO I ede aud o OE ORG ba RR EROR 60 The Staffing Analyzer s suggested indicators lt s40 0000 cede sane ee bie eee eu Sau waa wes 61 Varian e ce Rice chit ORR ad Kae eee eee ROE a eG Oe E ae he eee Ree wae 61 Reason for VariaiiCe e eros soos che quad ipse dte abe oW he hed eee ee bunds 62 Interventions stirs dG xe edu VERN ASDA Ae EASES ew ak hoa RR a i 65 SUMMARY PR TTE 68 2 Staffing Analyzer Simplifying
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12. Variance by shift The bar chart in Figure 1 11 shows the total variance for each shift of the day across an entire week in the unit Each bar on the chart represents a daily shift in the ICU The bar on the far right of the graph represents your total variance across all of your shifts According to this bar chart the ICU had understaffing problems in all but the last shift of the day The understaffing problem was worst during the 11 00 a m Variance by shift bar chart 1 19 00 Tofal All Shifts 15 ICU Week Begnining 12 8 2003 g STAFFING ANALYZER SIMPLIFYING DATA FOR NURSE MANAGERS User manual 3 Variance by staffing type The bar chart in Figure 1 12 is a representation of the daily total variance for each staffing type on your unit Each bar represents a staffing type at your facility The bar on the far right of the graph represents your total variance for the week This week in the ICU there was an understaffing problem for all three staffing types The most serious deficiency was with your LPN staff There were 21 instances during the week in which a shift was under staffed by LPN Variance by staffing type bar chart ICU Week Begnining 12 8 2003 0 Total All Types 5 10 STAFFING ANALYZER SIMPLIFYING DATA FOR NURSE MANAGERS 29 Chapter One 4 Reason for variance The graph in Figure 1 13 illustrates how many times you assigned a particula
13. ce value Cell D6 in this case When the variance is a negative number the word Understaffed will appear in the cell When the variance is a positive number the word Overstaffed will appear in the cell When the variance is zero the cell remains empty 20 STAFFING ANALYZER SIMPLIFYING DATA FOR NURSE MANAGERS User manual For examples of all three of these variance options refer to the screenshot in Figure 1 7 Day 1 screenshot 2 J Ricroatt Leock IPIE jm re ye mrn B EF LLY rhe toen m ta 7 c 3 3d Cinsdey Coni xuy Asv nctur pontem vies Varience duc zo Fieuton for Vsnnrace Totals Awe dee Cty Tene FAS ten Ax VO we yl Wels a amps 216 o i Wais og Lazar rene yann Isle If you are looking for the day s total variance by shift it is automatically generated by the Staffing Analyzer Scroll over to Column O on your worksheet which is titled Total Variance to see the totals If you are looking for the day s total variance by staffing type it is automatically generated by the Staffing Analyzer as well It appears in Row 72 titled Total Variance by Staffing Type and located beneath each of the staffing type columns STAFFING ANALYZER SIMPLIFYING DATA FOR NURSE MANAGERS 21 Chapter One If you scroll down below Row 72 you will also find a chart that includes the daily total for the following e Variance due to
14. del Y Reply with Changes lt gt e pur The Greeley Company Call PRN and parttime emplayeor Staffing Tool v1 5 Staff offered avertime 4th Shifl 13 00 Agency 5th Shift Transferstaffta another unit Organization Mame Staffrenthame Hospital Mame Department Icu Week Beginning December 8 2003 M 4 gt Config Data Weekly Summary Dayi Day2 Day3 Day4 DayS Day Ready Changing the organization name department name and week beginning date Your first customization responsibility is to customize the three cells that contain the Staffing Analyzer s default organization name department name and week beginning date When you open the Staffing Analyzer for the first time it will include a cell for you to type in the name of your organization It is cell A9 on the Configuring Data worksheet STAFFING ANALYZER SIMPLIFYING DATA FOR NURSE MANAGERS 9 Chapter One Editor s note When we refer to specific cells in a worksheet in this book we will use the letter that corre sponds to the column heading and the number that corresponds to the row heading This is similar to the way you find locations on a map To replace the default name Hospital Name with the name of your organization 1 Click on cell A9 2 Type the name of your organization over the current name This simple change is important
15. each through licensure and job descriptions Change in census The number of patients you cared for on the unit that day increased or decreased This indicator might be used to show a shift in which your unit provided care to transfers from another unit Change in acuity The acuity level of the patients you cared for on the unit that shift increased or decreased This indicator might be used to show a day in which your medical surgical unit provided care to patients transferred from the intensive care unit who require nurses with a higher skill level Staff absenteeism A scheduled member of your staff did not show up for his or her shift i e vacation illness jury duty and so on See Chapter four for more detailed explanations of these indicators and further discussion 2 Intervention As was the case with your Reason for variance indicators there are any number of interventions action taken that could be used to describe your response to an under overstaffing problem The Staffing Analyzer s suggested Intervention indicators appear in the second yellow column Column I on the Configuring Data worksheet An enlarged copy of the column appears in Figure 1 3 There are seven suggested Intervention indicators and eight blank cells where you may add additional indicators In order to solve your under overstaffing problem during this particular shift Call house staffing You called in another full time employee of the facili
16. ering your data into the Staffing Analyzer 4 cccccececne ced ar e RR RA ER 18 Step 1 Entering actual data pattern data and determining the variance 19 Step 2 Choosing a reason for Va IMICE Ls oae dou rsredee Se EE RE ee eee e EXER UEM 22 Step 3 Selecting interventions Intervention 1 and Intervention 2 4 23 Erasing changing a dropdown menu option you have already selected 23 When none of the dropdown menu indicators are applicable Ls 25 Staffing Analyzer Simplifying Data for Nurse Managers Contents Presenting your data eu V vex Vick CRX pa aa Sid wd wR VU d ODE EA ACC do CR d wR SRR ES 26 Explanation Of charts uos oeiu Ra FR EE RAG teeri deta eiea E CE RIPebbehrekeeds 27 Printing or copying bar charts Tor presentations 2 20u8 oes ves tEEer E te e402 32 Chapter Two Background on standards ratios budgets and more 33 JCAHO Sanat 05s Lao 4 ot Dad CES ada esr d bah ele Ue hee Se Vb edd ERES vitse td 35 Staffing data analysis and sentinel events ovra ever REIR REY 37 INurse to patient atios 3 users a tidak eee EEEE E NE EE E E e T WEE P EET KE Sa E es 38 Regsitered Nu rse Safe Staffing ACE sa a ace coa S Rea RC E N E ERER 38 ManG ater y OV ene su e ha Up X are 45 oe DEA dU P Oe CE EAE EE E 9E 40 Proposed Ies Ei IDE ud osx aqoa Res Tue OE OP CR CERCA ES Joe Oh eee ees 41 Budgeting Concerns ac a oca Re I Robot ARR ROC RURAL Loe hb EEN ERRARE OR RE ROS
17. ffered overtime In house registery actual 9ency Transfer staff to another M o4 gt WS Config Data Weekly Summary Staff sent home Ready Editor s note Note that the reason for variance you selected in Step 2 now appears in Cell D10 Continuing with our sick RN scenario let s assume that your one attempt to solve the RN understaffing problem during the 7 a m shift was to a call to an in house nurse working in another department Here Days f Day amp Day is how you would use the Staffing Analyzer to show this fact 1 Click on the down arrow in the box on the right side of Cell D12 A dropdown menu will appear 2 Move your cursor to the first intervention Call house staffing or the indicator that best repre sents your intervention For an explanation of this or other intervention indicators on the list see Chapter four 3 Left click on this indicator STAFFING ANALYZER SIMPLIFYING DATA FOR NURSE MANAGERS User manual The Staffing Analyzer places your selection in Cell D12 Most of your under overstaffing problems will not have initiated more than one intervention If you only used one intervention leave the cell for Intervention 2 Cell D14 blank If in this case you did use a sec ond intervention repeat the procedure for entering Intervention 2 Erasing changing a dropdown menu option you have already selected There will be instances where you make a select
18. fic worksheets The Staffing Analyzer condenses a week s worth of staffing data from this particular department or unit into the charts on this one page instantly as you work 26 STAFFING ANALYZER SIMPLIFYING DATA FOR NURSE MANAGERS User manual Explanation of charts Below are examples of the Staffing Analyzer s bar charts These sample charts were taken from the tool s Weekly Summary worksheet They are based on fictional data collected for an ICU for the week of December 8 2003 The ICU includes three staffing types RNs LPNs and NTs and four shifts starting at 7 00 11 00 15 00 and 19 00 The data in these examples were exaggerated to better show variation in the graphs 1 Variance due to The bar chart in Figure 1 10 represents how many times during the week your unit was understaffed or overstaffed factoring in all shifts and all staffing types In other words for each staffing type and shift this chart shows how many times there was a variance between your actual and planned staffing data During the week of December 8 the ICU was understaffed 30 times and overstaffed 10 times according to this chart For the remaining shifts and staffing types there was no variance between actual and planned staffing data FIGURE 1 10 Variance due to bar chart ICU Week Begnining 12 8 2003 35 30 25 Overstaffed Understaffed STAFFING ANALYZER SIMPLIFYING DATA FOR NURSE MANAGERS 27 Chapter One 2
19. in turn offered another staff member overtime compensation for covering that shift STAFFING ANALYZER SIMPLIFYING DATA FOR NURSE MANAGERS 7 Chapter One We recognized these facts when we designed the Staffing Analyzer We have provided some of the more frequently identified reasons for staffing variances and responses taken to correct those variances You will also notice we have left several cells blank anticipating that this is where you will add your unique reasons for staffing challenges and interventions Keys to customizing The key to effectively analyzing staffing data with this tool relies on your ability to individualize or cus tomize this tool to reflect your organization s staffing types shift changes reasons for under overstaffing challenges RW N e the typical responses or actions taken to remedy those challenges Fortunately for you customizing this tool is simple and can all be done in one place the Configuring Data worksheet See Figure 1 1 This is the first worksheet in the Staffing Analyzer workbook If you are not there already click on the Config Data tab at the bottom of the workbook 8 STAFFING ANALYZER SIMPLIFYING DATA FOR NURSE MANAGERS User manual Configuring Data Worksheet El Microsoft Excel RN STAFF 1 5 Ej File Edit View Insert Format Tools Data Window Help il o B z u amp e s Hi x 58 ee dg Du ESu amp el tY BBS 0 o amp r 20 ib dI A sm S H
20. ion from the dropdown menu that you later decide was incorrect How do you go back and change that If you realize another option on the dropdown menu is more appropriate click on the cell with the incor rect information and use the down arrow to find and select another option If you realize that there is no option that is appropriate or necessary highlight the complete text of the option selected and press DELETE on your keyboard Data in this cell is connected to a dropdown menu therefore clicking on the cell and retyping will not erase the option as is the case with other cells When none of the dropdown menu indicators are applicable If the most applicable reason for your staffing variance or intervention undertaken to solve your staffing problem does not appear on the respective dropdown menu you have two options 1 Leave the cell blank This is best for one time or infrequent incidents that you do not wish to track 2 Go back to the Configuring Data worksheet and customize your Intervention dropdown menu again adding the applicable reason This is best if you plan on analyzing or tracking that reason As discussed in the Customizing Your Staffing Analyzer section putting None or Not Applicable will mean these interventions will be tracked and will appear on your graphs STAFFING ANALYZER SIMPLIFYING DATA FOR NURSE MANAGERS 25 Chapter One Presentingyour data The Staffing Analyzer is not
21. n house registery Transfer staff to another unit Call PRN and part STAFFING ANALYZER SIMPLIFYING DATA FOR NURSE MANAGERS 31 Chapter One Printing or copying charts for presentations When it comes time to present this data to administrators JCAHO surveyors state licensing officials staff or anyone else who may be interested there are easy steps you can follow in order to create hard copy or electronic versions of these bar charts Creating a hardcopy version of a bar chart 1 Move your cursor on to the graph you would like to print 2 Left click anywhere on the graph 3 On the File menu point to Print Including the bar chart in a PowerPoint slide show presentation and other applications 1 Move your cursor on to the graph you would like to copy 2 Right click anywhere on the graph except between the x and y axis and point to Copy 3 Go to the destination document in which you would like the graph to appear Right click and point to Paste For more suggestions and guidance on presenting your data including descriptions of other chart options refer to Chapter six Now that you know how to get the most out of the Staffing Analyzer it s time to examine how best to collect analyze and present staffing data 2 STAFFING ANALYZER SIMPLIFYING DATA FOR NURSE MANAGERS HCPro Order your copy today Please fill in the title price order code and quantity and add applicable shipping and tax For price and
22. ning on your computer is included on the CD ROM that accompanies this book Here are answers to common questions about how to get your version of the Staffing Analyzer up and running What type of computer do I need to use the Staffing Analyzer The Staffing Analyzer must be used on a personal computer PC that includes Microsoft Excel software The Staffing Analyzer cannot be used on a Macintosh computer at this point in time How do I install and open the Staffing Analyzer on my computer 1 Place CD ROM in your computer s CD ROM drive 2 Double click on your CD drive 3 Find the file called RN STAFF v1 5 and double click on it The Staffing Analyzer workbook should now be open on your monitor How do save a template copy of the Staffing Analyzer on my computer 1 Go to the File menu point to Save As 2 In the File name box enter a new name for the file Staffing Analyzer Template Where is the best place to save the Staffing Analyzer on my computer It is at this point that you will need to decide where you would like to store your Staffing Analyzer Template There are a number of suggested places 1 A folder on your computer s hard drive called My Documents or My Programs either of which may be the default setting for your computer 2 A new folder on your hard drive 4 STAFFING ANALYZER SIMPLIFYING DATA FOR NURSE MANAGERS User manual 3 Your desktop 4 A folder on the facility s computer netw
23. or your organization you need clear definitions of what each option means To help you decide we have included a column by column description of the options we have included for you in the Staffing Analyzer below Whichever indicators you choose to create keep the wording short These indicators will show up later on bar charts Indicators that are long or wordy may affect the appearance of the charts 1 Reason for variance This column is where you create the typical reasons that may explain why one of your particular staffing types was under overstaffed in a particular department during a particular shift The Staffing Analyzer s suggested Reasons for variance options appear in the first yellow column on the Configuring Data worksheet Column F An enlarged copy of the column appears in Figure 1 2 There are four suggested indicators Below those indicators are six blank cells where you may enter additional indicators Reason for variance Reason for Variance eI In eem emm i eem STAFFING ANALYZER SIMPLIFYING DATA FOR NURSE MANAGERS User manual The suggested indicators are listed below The description for each reason indicator completes the fol lowing sentence You would use this indicator if the reason you were under overstaffed was because Skill mix The various skill levels of staff were inappropriate based on patient acquity skills required and the roles and responsibilities assigned to
24. ork It is up to you to decide where to save it We suggest you save it to your facility s network and backup your work frequently It doesn t matter if you choose one of these four suggestions or use one of your own The only requirements are that wherever you decide you know where you are you know how to get back there What is the best method for sharing the Staffing Analyzer with colleagues Perhaps you have more than one nurse manager or senior staff nurse responsible for analyzing and pre senting staffing levels data within your organization There are two easy ways to share the Staffing Analyzer 1 Store your version of the Staffing Analyzer Template on to your facility s network in a location where everyone who needs to use the tool can access it 2 Give CD ROM to your colleague and have him or her download a copy of the Staffing Analyzer Template on his or her computer Enabling and disabling macros When you open the Staffing Analyzer you will be notified that this tool contains macros that may not work due to your computer s security settings A macro is a single instructional command that is embedded in the tool and stands for a sequence of operations In this case the macros are tied to the operation of the tool s dropdown menus To use the Staffing Analyzer you need these macros to be enabled When the warning box appears click Enable Macros If your computer does not allow you to enable
25. oughout all of the shifts at your facility When you reach the bottom of the staffing type column move back to the top of the worksheet and enter data down the sheet for the next staffing type 18 STAFFING ANALYZER SIMPLIFYING DATA FOR NURSE MANAGERS User manual No one way is better than the other Your decision will likely be based on the way in which the staffing data you collected is organized If the unit specific staffing data you are entering is organized by shift it will probably be easier to work horizontally If your unit specific staffing data is organized by staff type it will probably be easier to work vertically Step 1 Entering actual data pattern data and determining the variance The first section of the day specific worksheet that requires you to enter your staffing data involves entering your actual staffing data entering your pattern staffing data and then recognizing and understanding the variance Begin by entering your staffing data for the 7 a m shift The section of the day specific worksheet in which you will be working appears in Figure 1 6 Day 1 screenshot 1 amp Microsoft Excel RN STAFF V1 5 File Edit View Insert Format Tools Data Window Help Arial 710 B 7 u Eje 97 85 5 5 A Dc EGu amp lI Y SB8 amp 40 c amp r 5 z 4d B G ta 3 23 V a v Vu ge YeReply with changes i D4 Y fe B F H c A Driss tin Department Name ICU 1 The Greeley Compan
26. pes Changing the indicators We cannot emphasize enough that these indicators and options can be changed at any time After using the tool for a month you may discover newer more specific reasons for your over understaffing that are more effective than the options you originally created Or you may find that an intervention action taken that was common when you customized this tool the first time is now discouraged by your administration or perhaps illegal due to new state or federal regulations The customization of this tool should be an ongoing process There should be regularly scheduled assessments under the supervision of the user to determine whether the current options best reflect the current staffing challenges and action taken at your organization Editor s note Whenever you do make a change to the indicators develop a process for documenting the date when that change occurred In some instances this will help you to explain unexpected data trends For example you notice a sharp spike in the times you called in agency nurses occurred in the first two weeks of November What caused this spike A look back at your record of changes reveals that you added an option to your Reason for variance menu on November 1 reflecting the nursing strike that began on that day STAFFING ANALYZER SIMPLIFYING DATA FOR NURSE MANAGERS 17 Chapter One Enteringyour data into theStaffing Analyzer Now that you have finished cus
27. r understaffed There are four remaining items on this worksheet that need to be customized to fit your organization or facility 1 Reason for variance 2 Intervention 3 Shifts 4 Staffing types Each of these four items appears as a heading above a yellow column on the Config Data worksheet These yellow cells beneath those column headings contain the default or suggested indicators for those headings Customizing your dropdown menus The first two customizable columns reason for variance and Intervention will appear in the dropdown menus you will use later on the day specific worksheets We will discuss how to use these dropdown menus later in the Entering Your Data section of this chapter Remember that the suggested indicators that appear in these columns are just that suggestions It is pos sible that every organization that uses this tool will have a unique set of indicators for these categories Your diligence in customizing these dropdown menus will determine the effectiveness of this tool Keep in mind that you can use all of these indicators as they are written some of these indicators and edit others some of these indicators and leave the rest blank none of these indicators and enter your own Or you can do any combination of the above suggestions STAFFING ANALYZER SIMPLIFYING DATA FOR NURSE MANAGERS 11 Chapter One 12 Before you can decide whether our suggested indicators are right f
28. r reason for a variance dur ing the week Each of the bars represents one of the indicators you created on your Reason for variance dropdown menu According to this graph the reason most often cited for your under overstaffing problem in the ICU this week was due to a change in census Reason for variance bar chart ICU Week Begnining 12 8 2003 18 16 14 12 10 16 Skill mix Change in census Change in acuity Staff absenteeism 30 STAFFING ANALYZER SIMPLIFYING DATA FOR NURSE MANAGERS User manual 5 Interventions The graph in Figure 1 14 shows how many times you used a particular intervention actions taken to correct a variance between your actual and pattern staffing data during the week Each of the bars repre sents one of the indicators you created on your Interventions dropdown menu According to the graph your most frequent response to under overstaffing problems this week in the ICU was to offer overtime to staff followed by transferring staff to another unit to correct an overstaffing problem and calling house staffing We will discuss how these charts can be used to identify and analyze trends and lead to more effective presentations throughout the remainder of this book Interventions bar chart ICU Week Begnining 12 8 2003 14 12 EN o Staff offered overtime Staff sent home a Call house staffing time employees I
29. rse cont Editing cell contents 1 Double click the cell that contains the data you want to edit 2 Edit the cell contents 3 To enter or cancel your changes press ENTER or ESC Clearing deleting cell contents When you clear cells you remove the cell contents formulas and data formats including number formats conditional formats and borders or comments but you leave the blank cells on the worksheet 1 Select the cells rows or column you want to clear any contents 2 On the Edit menu point to Clear and then click All When you delete cells by clicking Delete on the Edit menu Microsoft Excel removes them from the worksheet and shifts the surrounding cells to fill the space All the cells in the Staffing Analyzer workbook however are locked and cannot be deleted Undoing redoing an action 1 To undo actions one at a time go to the Edit menu and click Undo Typing 2 If you change your mind go to the Edit menu and click Redo Typing Customizingy our Staffing Analyzer Every health care organization faces its own unique set of staffing challenges and each responds to those challenges in a different way Therefore no two organizations that use the Staffing Analyzer will do so in the same way That is not to say there are not staffing challenges and responses that are universal Every nursing super visor has had a staff member call out sick or go on vacation jury duty and so on Further every nurse manager has
30. ta for years most lack a consistent process or approach for collecting this data As a result these directors have no idea where to begin in establishing staffing norms and practices on their units Enter the Staffing Analyzer In addition to organizing your staffing data the Staffing Analyzer allows users to customize dropdown menus to provide answers to the following questions What is the reason for the over understaffing for that shift e What was the intervention used action taken to address the underage or overage The Staffing Analyzer organizes per shift data daily for each unit for a week s worth of data The spread sheet will then aggregate the data over a week s time to arrive at trends for that week Each unit s manager is meant to enter the data for her or his unit only then forward the data on a weekly or monthly basis to the director of nursing or a nurse administrator The spreadsheet is designed to create and display presentation charts and graphs of staffing variances rea sons for variance and interventions so that managers at the unit level and director level can identify and present trends more easily STAFFING ANALYZER SIMPLIFYING DATA FOR NURSE MANAGERS 3 Chapter One The Staffing Analyzer is the only resource you will need to set up a process for analyzing staffing data or revitalize the one you already have Gettingstarted Everything you need to get the Staffing Analyzer up and run
31. tomizing the Configuring Data worksheet you can start entering your staffing data into the day specific department worksheets For the purpose of this manual assume the following scenario You have collected staffing data taken from your facility s Intensive Care Unit ICU on December 8 2003 That day you had four RNs five LVNs and six NTs on duty The budget called for five of each If you are not already in the worksheet titled Day 1 click the tab called Day 1 at the bottom of the workbook First verify that Department Name and Date appear correctly at the top of worksheet in which you are working If the either or both are incorrect turn back to the Customizing your Staffing Analyzer section to learn how to customize these items You can choose to enter your data into the day specific worksheets any number of ways The two most logical ways to enter data are Horizontally by shift Vertically by staffing type If you choose to work horizontally start at Cell D4 and work left to right to enter the actual and pattern data for every staff type on the unit during your first shift of the day After your first shift move down the sheet to your second shift and work horizontally left to right once again entering data for each staff type on the unit during the second shift and so on If you choose to work vertically you will also start at Cell D4 but enter the actual and pattern data for one staff type thr
32. ty to work that shift on your unit STAFFING ANALYZER SIMPLIFYING DATA FOR NURSE MANAGERS 13 Chapter One Intervention Intervention n Crll ous sb fing n Crll PRiinnd pr tiac cinployecs v DICEN eism L3 Tmrerke sio nino her unit Call PRN as needed and part time employees You called in PRN and part time employees of your facility who work fewer than 40 hours per week and therefore would not need to be paid overtime Staff offered overtime You offered overtime wages to the current staff on the unit during that shift to entice them to stay for an additional shift In house registry You contacted the nursing office s registry a group of employees who had previously expressed interest in overtime hours whenever they are made available Agency The hospital contacted an outside nursing agency that sends over a contract nurse Transfer staff to another unit A nurse on your unit was transferred out because you are overstaffed 14 STAFFING ANALYZER SIMPLIFYING DATA FOR NURSE MANAGERS User manual Staff sent home A nurse on your unit was sent home because of a change in census See Chapter four for more detailed explanations of these indicators and further discussion The final two pieces of the Configuring Data worksheet that need to be customized before you begin entering data are the shifts and staffing types columns 3 Shifts The Staffing Analyzer s suggested shift starting times
33. y d Date 12 08 03 LVNILPN actual pattern variance Variance due to X Reason for Variance Y intervention 1 v intervention 2 L0 Mo 4 MN Config Data Weekly Summary X Day1 f Day2 Day3 4 Day4 4 DayS 4 Day6 4 Day 7 4 Ready STAFFING ANALYZER SIMPLIFYING DATA FOR NURSE MANAGERS 19 Chapter One Actual data Actual data is the number of staffing type members you had in the selected unit during the selected shift on the selected day 1 Click on Cell D4 on your worksheet 2 Enter the number of RNs LVNs and NTs you had in the ICU during the 7 a m shift See Figure 1 7 3 Press ENTER Pattern data Pattern date is the number of staffing type members you had budgeted for the selected unit during the selected shift on the selected day 1 Click on Cell D5 on your worksheet 2 Enter the number of RNs LVNs and NTs you had budgeted to be in the ICU during the 7 a m shift See Figure 1 7 3 Press ENTER Variance The variance which is the numeric difference between your pattern and actual data appears beneath your actual and pattern data in Cell D6 A formula imbedded in each staffing type column of the department worksheet calculates the variance for you The variance will appear as either a negative number positive number or zero The data for the Variance due to cell is automatically generated by the Staffing Analyzer as well It is based on the varian
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