Top 3 Nursing Priorities In A Hospital

by | Dec 19, 2012

One of the first questions we asked our survey respondents was to choose their top three priorities in their hospital today. We wanted to see if scheduling and staffing – those things that are impacted directly by a staffing office – made the list of concerns. Our assumption is that it is a major concern, and that’s why we were doing the survey. However, if it didn’t make the top three, it could mean that no one really cares or worries about it and that would be enlightening because it means our assumptions would be way off base.

As a side note, our survey respondents were a mix of CNO’s, Nursing Directors, Managers, and a scattering of others including RN’s and IT management.

We gave the respondents the following list of potential priorities or issues to choose from:

Achieving Magnet Status

Joint Commission Readiness

Adopting ACO Compliance Measures

Implementing EHR

Controlling Staff Labor Costs

Managing Staff Shortages

Improving Payor Mix

Preparing for Federal Changes to Medicare/Medicaid

Other Priorities

To give the opportunity for more variety, we left “Provide Quality Patient Care” off of the list, because we know that is an overarching priority that everyone would select first if it were out there.

We let each respondent choose a first, second, and third priority. With the response counts, we then weighted each answer to give three points for the first priorities, two points to the second, and one point for the third.

What do you think was the top priority?

It was [drumroll…] a tie! The two top priorities selected were “Implementing EHR” and “Controlling Staff Labor Costs,” each with twenty-four percent of the total possible points. The solid third place priority was “Preparing for Federal Changes to Medicare/Medicaid” with another sixteen percent of the points. The remaining points were scattered almost equally amongst the other choices.

Interestingly, “Implementing EHR” was selected as the #1 priority in twenty-four percent of the surveys versus only eighteen percent for “Controlling Staff Labor Costs.” But the labor costs priority made up the difference in second and third place priorities.

To me, this makes sense and reinforces the assumptions we have. EHR is a big concern because it is technology-driven and makes such a significant impact on nursing day-to-day operations. The IT aspect of makes more of a concern than normal because nursing has less control over it than a similarly impactful priority that is owned by nursing (like Magnet Status). On the labor costs side, since anywhere from forty to sixty percent of a hospital’s gross revenues can go to labor, of which nursing makes up the largest percentage, controlling those costs as a priority also makes sense. We’ve talked about in this blog before, how balancing labor costs and quality patient care is a significant challenge. Overall conclusions:

We’re on the right track. Staffing offices directly impact the deployment of nurses in shifts, and when nurses are deployed, they must be paid! The ability for a hospital to control their costs can be significantly impacted by the effectiveness of the staffing office.

Another conclusion – Nursing gets concerned about high impact technology initiatives (like EHR) so that needs to be kept in mind when we think about staffing office. We like to think of technology being a solution to solving problems but will we see that being the case in this survey? More to come on that.

What are your thoughts on these priorities? Do you agree with the survey results? Is there anything surprising about them? Share your thoughts with us below in the comments or send us a note on Twitter to @FlandersChris or @Axsium.



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