Hospitals are under increasing pressure to improve care, lower costs and avoid nurse burnout and turnover. One overlooked area is the patient assignment process, which could benefit from intelligent software. This slide presentation lays out the case for it.

1. Evidence-based Patient
Assignments
How Using Automation and Intelligent Software Could Contribute to
Improving Care in Hospital Nursing Units
Gene Pinder
MedAptus, Inc.
www.medaptus.com

2. Numerous studies in
nursing have shown
how heavy
workloads adversely
affect care.

3. There is good scientific
evidence of an
association between
lower nurse workloads
and better patient
outcomes, including
lower hospital mortality.
(Aiken, et al. 2008)
Here’s how one
of the top
nursing
researchers
described it:

4. Other studies point
towards heavy
workloads affecting
employee satisfaction
– which in turn
contributes to burnout
and turnover among
nurses.

5. When patient
assignments aren’t
equitable, nurses may
feel inadequate and
frustrated.
Kidd, et al. (2014)

6. The problems are not
trivial. In fact, they are at
the heart of what ails
healthcare today…
The continued pressure to
maintain quality care with
limited personnel and
lower costs.

7. It’s one reason why
scheduling
software programs
have become more
popular.

8. But that’s only part of the
equation.
The other part is
patient assignments.

9. Patient assignments can
make or break a nursing
unit’s level of care.

10. Get them right and good
things follow. Get them
wrong and all kinds of
problems can occur.

11. Effective execution of the nurse-to-
patient assignment process has the
potential for significant safety,
quality, and business implications
(Douglas, 2011)
One researcher put it this
way:

12. For example…
If a patient with high acuity
is not factored into the
assignments, the nurse
assigned to that patient will
be challenged to care for
his or her other patients
during the shift.

13. Using patient acuity tools
could help, but they’re
often cumbersome and
taxing and don’t really solve
the one vexing problem on
every shift.

14. How do you balance
assignments so that nurses
aren’t unfairly taking on a
disproportionate number of
complex patients?

15. Assigning by geography has
been the standard
technique for many floors.

16. But what if a particular pod
has a large number of
difficult assignments?

17. The reality is – assigning
patients manually requires
juggling all kinds of
variables – including
geography, patient acuity
and even continuity.

18. And yet, combining and
juggling these multiple
variables – while still trying
to maintain fairness and
equity – is nearly
impossible.

19. Some use spreadsheets to
try to figure it out.

20. But not only does that quickly become
complicated, but it eats up a lot of time for the
person trying to make up the list.
Yes, it’s an option, but it’s less than ideal.
It still doesn’t satisfy frustrated nurses who
think they’re being treated unfairly.

21. The problem is
compounded by the fact
that most people aren’t
trained to handle
assignments.
For most – like charge
nurses – it just falls in their
lap and they’re expected to
“get it done” and “get it
right.”

22. Researchers have now
begun to look at how
patient assignments
affect care and the
evidence is building…
Suboptimal patient
assignments adversely
affect care.

23. If the assignments
don’t improve
workloads and if
they frustrate and
already
overburdened
staff…
Then care is going
to be
compromised.

24. Is there a better way?

25. What about patient acuity tools?

26. They tell which patients are sick and
at what level…but they still don’t do
the actual balancing. That still has to
be done by the charge nurse or
person doing the assignments.

27. The only real viable solution is
software specifically created for
patient assignments.

28. Why?
Because the software can do what
humans can’t…
…Take multiple variables or
combinations and calculate them
quickly and effortlessly.

29. That’s not to say that human
interaction isn’t necessary or
important.
You still have to determine what
variables are important.
And there are always exceptions,
deletions and changes that need to
be made.
Besides, no software program is
perfect.

30. But the real beauty of
using software is that
it takes a lot of
guesswork and
personal bias out of
assignments and
automates them. It
also completely
handles the
complexity.

31. The result – workloads that are fair
because the software has balanced
them – using the criteria each unit
decides is important.

32. Patient assignment software isn’t
going to solve all of the problems
associated with nurse burnout or
understaffed units.

33. But it does improve a process right
now that is currently suboptimal in
most hospitals and is jeopardizing
care.
It also gives the people who do
assignments a much needed boost. It
helps them do their jobs a lot better.

34. This is where a
shameless plug is inserted.

35. Medaptus has built a sophisticated patient
assignment software program - called
ASSIGN for Nurses.
It automatically and intelligently matches the right
patients with the right nurses and balances
workloads – all in just a few minutes.
Here’s the URL in case you want to check it out:
www.assignfornurses.com

36. To summarize…
The problems associated with patient
assignments aren’t going to solve
themselves on their own or go away any
time soon.
That means if not done well or if they are
ignored, quality care is compromised and
nurse burnout and turnover will continue to
be a likely outcome.
Now that it’s been created, maybe it’s time
to put patient assignment software to good
use.

37. Thanks for viewing this slide
deck. We hope it was worth
your time and that your
patient assignment process
greatly improves in 2018.
If you would like to see a
partial list of some of the
research we’ve used to help
demonstrate the need for our
software, see the next slide. A
full listing of the research is on
our website.

38. Partial List of Research Studies Related to Patient
Assignments and Nurse Workloads
The Nurse-Patient Assignment: Purposes and Decision Factors.
Allen SB1.
J Nurs Adm. 2015 Dec;45(12):628-35. doi: 10.1097/NNA.0000000000000276.
Phase I: creating an electronic prototype to generate equitable hospital nurse-to-patient assignments.
Baker RL1, Tindell S, Buckley Behan D, Turpin PG, Rosenberger JM, Punnakitikashem P.
Comput Inform Nurs. 2010 Jan-Feb;28(1):57-62. doi: 10.1097/NCN.0b013e3181c0472c.
Expanding the Parameters for Excellence in Patient Assignments: Is Leveraging an Evidence-Data-Based Acuity Methodology
Realistic?
Gray J1, Kerfoot K.
Nurs Adm Q. 2016 Jan-Mar;40(1):7-13. doi: 10.1097/NAQ.0000000000000138.
Developing and testing a computerized decision support system for nurse-to-patient assignment: a multimethod study.
van Oostveen CJ1, Braaksma A, Vermeulen H.
Comput Inform Nurs. 2014 Jun;32(6):276-85. doi: 10.1097/CIN.0000000000000056.
Inequity of patient assignments: fact or fiction?
Marine K1, Meehan P, Lyons AC, Curley MA.
Crit Care Nurse. 2013 Apr;33(2):74-7. doi: 10.4037/ccn2013399.
Starting the shift out right: The electronic eAssignment sheet using clinical decision support in a quality improvement project.
Massarweh, Lisa & Tidyman, Travis & H Luu, David.
Nursing economic$. 35. 194-200.
Modeling nurse-patient assignments considering patient acuity and travel distance metrics.
Acar I, Butt SE.
J Biomed Inform. 2016 Dec;64:192-206. doi: 10.1016/j.jbi.2016.10.006. Epub 2016 Oct 11.