Wednesday, March 20, 2013

AONE 2013 Patient Need Based Acuity

My husband ran a distribution center  for 13 years.  When we met had around 150+ employees and through automation, software, and workflow modification was able to reduce the employee count to less than 10% of that number.  His guiding principal was to break tasks down and manage the individuals according to the time it took an average person to accomplish the task.   He and his team could watch a process and identify skills sets and aptitudes that allowed them to manage the team to accomplish the goal in a timely way with a low error rate.

As I have researched acuity it seems to be a similar structure.  The DRG defines a grouping of tasks and the tasks have an associated average time of completion (geeks call this a weight) and the assignment is made based on how many “tasks” can be completed within a shift.  Then the patients are assigned to the caregivers based on the workload associated.  That’s when I started to ask questions….are we treating nurses like assembly line workers?   How does this affect how we assign them to a patient – does our technology really support the mindset?
I have watched this process at a number of hospitals, interviewed a number of managers and I do believe that it’s much more of an art than a science.    In the last few years I have also observed several production facilities - from a Milk Farm to a Coffee Roasterie to Electronics manufacture.  The thing that jumped out at me……the product or coffee bean or electronic doesn’t drive any additional demand or strain on an assembly workers day.  There are outliers where a piece of material is bad but for the most part it’s pick up the widget, put it in a box, etc.   The point is – the widget doesn’t ask for ice chips when you are trying to complete other assigned tasks....the widget dosen't code.   

I get it – there has to be a way to balance the workload of the caregiver and acuity (aka task management) seems to be the best method.  I am not trying to disregard the years of research and work done in creating the tasks associated with diagnosis, etc  but there is more here than just a task list.  We at Sphere3 believe there is a way to capture additional information to make assignment of patients easier and managing the workload more effective.  Stop by and check it out.
I am eager to see at AONE this week how many vendors try to tout their technology as a way to reduce staff….be careful with those statements… should be an enabling tool the data should give the ability to manage the workload more effectively.  Patients aren't Widgets – Caregivers aren’t assembly line workers.   

If you would like to see how Aperum® can help your facility better manage workload of your caregivers stop by BOOTH 727 this week at AONE.

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Kourtney Govro