The five rights of staffing: Maximizing the clinical and financial benefits of an acuity system

Hospitals and health systems often purchase acuity systems as a valuable tool to allocate nursing resources based on patient care needs. However, these organizations don’t always use their acuity systems to their full capability. In many cases, at least one of what we call “the five rights of staffing” is absent.

According to “the five rights of staffing,” an acuity system should give hospitals:

1)    the right number of staff

2)    with the right skills

3)    at the right location

4)    at the right time

5)    with the right assignment

The maximum benefits from an acuity system can be achieved when these five aspects are used together to efficiently leverage existing nursing resources, preventing the need to rely on expensive options such as outside staffing agencies. To do this, managers must assess more than just patient census and hours-per-patient day. They must also look at the hours of care the patient needs, based on workload, and the patient’s unique professional care requirements to effectively match staff to patients.

This requires taking both the acuity and complexity of patients into account when making assignments. A patient who needs a higher level of nursing intervention, for instance, should be assigned a more seasoned nurse instead of one right out of school. Looking at the complexity and acuity of care is likely to result in more efficient staffing levels, improved patient safety, and better patient outcomes.

A case example: Evaluating staffing patterns with acuity

Northeast Georgia Medical Center in Gainesville, Ga., offers one example of a facility that uses acuity to evaluate its staffing patterns—at both the executive and unit levels—to drive efficiencies. However, that wasn’t always the case. A few years ago, the facility’s nursing leadership and finance department met to discuss its staffing processes. They had an acuity system, but it wasn’t being fully utilized. The group believed that nursing resources should be based on the needs of patients. As a result, the team decided that it was necessary to incorporate patient needs-based staffing processes into the organizational culture.

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