Demand management: A methodology for outcomes-driven staffing and patient flow management

Along with the Institute of Medicine's 2004 study report, “Keeping Patients Safe: Transforming the Work Environment of Nurses,” extensive research consistently shows a strong correlation between adequate nurse staffing, patient outcomes, and patient safety.1, 2 and 3 Yet no one has defined a method to establish “adequate” staffing, how to continuously provide it, and what the appropriate staffing characteristics (ratios, skill mix, etc) are.Nurse leadership appropriately challenges recent legislative efforts to mandate simple patient-to-nurse ratios as a method to ensure quality and safety, due to the high variability in unit types, nurse intensity, and care complexity. 4 There is growing consensus that traditional staffing models are inadequate to ensure safe, effective levels of care and that hospital organizations need a new, evidence-based model to effectively guide the management of and strategies for safe, effective, cost-correct staffing.