The document describes the Workload Indicators of Staffing Need (WISN) methodology for calculating health workforce requirements based on actual workload. WISN involves estimating available working time, defining work components and activity standards, calculating standard workloads, and determining staffing requirements based on service activities, category allowance factors, and individual allowance factors. It provides an example calculation of medical officer requirements at a specialist hospital using WISN and analyzes workforce problems based on WISN differences and ratios.

1. WISN
BAHAGIAN PERUBATAN
JKN PERAK

2. INTRODUCTION
• Objective of workforce planning :
To place
• Right people
• In the right place
• At the right time
• With the right skills and education
• Of the right skills mix

3. HUMAN RESOURCE MANAGEMENT
• Plan the number and type of HRH it requires
• Allocate HRH to different health units
• Methods :
a) Old method : - Population ratio
- Fixes staff schedule
b) New method : - WISN
• Weakness of old method : Ignore local
differences in the amount and type of work
that health workers do

4. WISN
• New method based on the actual work that
health workers do (workload).
• Can be applied to - medical staff
- paramedic
- non-clinical staffs
• Useful : - calculating both current and future
HRH requirements.
- comparing level of HRH in different
areas or health facilities.
- Indicates how much work pressure
HRH are under

6. STEPS IN WISN METHODOLOGY
1. Set WISN target
2. Estimate Available Working Time (AWT)
3. Define components of work
4. Set activity standards (service standards &
allowance standards)
5. Calculate standard workloads
6. Calculate allowance factors
7. Calculate required staff requirement

7. 1. Set WISN target
• Select staff category
• Type of facility (hospital, KK, Unit)
• Geographic areas (remote KK vs urban KKs)

8. 2. Estimate Available Working Time(AWT)
No Item Days eg
1 Working day / week A 5
2. Working days/year B (Ax 52) 260 (5x 52 )
3 Annual leave C 30
4 Public holidays D 18
5 Sick leave E 7
6 Special leave F 0
7 Working hrs/day G 8
Contoh :
AWT = B- (C+D+E+F) days /year 260-(30+18+7+0) =205
=H

9. CONVERTING AWT TO OTHER UNITS
• Days / year = H x 8 hrs = hrs/year
= H x 8 x 60 = min/year
Contoh 205 working days /year
= 205 x8 =1640 hrs/year
= 205 x8x60 = 98400min/year

10. 3. Define work components
Workload group Workload component
Health service activities of all cadre
groups
Support activities of all cadre groups
Additional activities of certain cadres
members

11. 4. Set Activity Standard
• Definition:
The time it takes a trained and well-motivated
member of a particular staff category to perform
the action to acceptable professional standards
in the circumstances of the country.
• Two types of Activity Standards
- Service Standards
- Allowance Standards
• Shown as unit time

12. Activity Standard
Health service activity Unit time
Service standards
Category allowance factors
Individual allowance factors

13. Service Standards
Health service activity Unit Time
Outpatient consultation min/patient
Procedure min/patient
Ward round min / patient
Grand ward round hrs/session

14. CATEGORY ALLOWANCE STANDARD
• For activities that are not reported in annual service
statistics
Activity Unit time Proportion of AWT
QA activity 2 Hrs/ week Eg 2hrs/wk = 2/8x5 =
0.05
CME 1 Hr/week Eg 1 hr/wk = 1/40=0.025
Training (LDP) 7 days /year Eg 7/205 = 0.034
Meeting 2 Hrs / month Eg 2x12/1640= 0.014
Reporting 4 Hrs/week Eg 4 /40 = 0.1
Total CAF/100 0.05+0.025+0.034+0.1=
0.209
Allowance multiplier = __1___ = 1.264
1- 0.209

15. INDIVIDUAL ALLOWANCE FACTORS
• For activities that are not reported in annual
service statistics done by selected staffs
Activity No of Unit time Proportion of AWT
staffs
involved
Doing returns 1 4 hrs / 4/ (4x40)= 0.025
month
Stock checking 2 2 hrs / 2 x 2/(4x40) = 0.025
month
Supervision of 1 4 hrs / 4x12/1640 = 0.029
students month

16. Standard Workloads
• Definition :
Amount of work (within one activity) that one person
could do in a year.
• If expressed as unit time for the activity:
Std. workload = Available working time in a year
Unit time for the activity
• If expressed as rate of working:
Std. workload = Rate x Available working time in a year

17. Standard Workloads
Staff category : Medical officer
AWT in a year = 205 days/ 1640 hrs /98400 min
Health service Unit time or rate of Standard workload
activity working
Outpatient consultation 10 min/patient 98400/10= 9840
pts/year
Procedure 2 hrs/day 8/2 x 205 = 820
proc/yr
Ward rounds 15 min /patient 98400/15 = 6560
pts/yr
Grand ward round 1 session/week 52 x1 = 52 grand ward
round /year

18. DETERMINING STAFF REQUIREMENTS
• Total staff requirements = (staff required for
service activity X staff requirement (CAF) +
Staff requirement (IAF)

19. SAMPLE CALCULATION : MO IN SPECIALIST HOSPITAL
MEDICAL DEPT
WORKLOAD CATEGORY WORKLOAD COMPONENT
Service activities • Outpatient consultation
• Ward rounds
• Procedures
• Grand ward rounds
Category allowance factors • QA activities
• CME
• LDP
• Meeting
• Reporting
Individual allowance factors • Supervision of students

20. STAFF REQUIREMENT FOR SERVICE ACTIVITY
(A)
Staff category : Medical officer
AWT in a year = 205 days/ 1640 hrs /98400 min
Health service Unit time or Standard Annual work load Staff requirement
activity rate of working workload
Outpatient 10 min/patient 98400/10= 9840 10,000 out pt 10,000/9840=
consultation pts/year 1.016
Procedure 2 hrs/day 8/2 x 205 = 820 1000 hrs 1000/820 =1.220
hrs /yr
Ward rounds 15 min /patient 98400/15 = 6560 6000 inpts 6000/6560=
pts/yr 0.915
Grand ward round 1 session/week 52 x1 = 52 grand 46 grand ward 46/52 = 0.885
ward round /year rounds
Staff requirement based on service activities = 1.016+0.915+1.220+0.885 = 4.036

21. STAFF REQUIREMENT FOR CAF
(B)

22. STAFF REQUIREMENT BASED ON IAF
(C)
Activity No of staffs Unit time Proportion of
involved AWT
Supervision of 1 4 hrs / month 4x12/1640 =
students 0.029

23. TOTAL STAFF REQUIREMENT BASED ON WISN
• Total staff requirement = (AXB) +C
= (4.036x1.264) +0.029
= 5.130

24. ANALYSIS & INTEPRETING WISN
• WISN difference : difference between current
and required staffing levels
-ve : shortage
+ve : surplus
• WISN ratio : current staff/ required staff
< 1.0 : high work pressure
> 1.0 : low work pressure

25. EXAMPLE OF ANALYSIS
STAFF CATEGORY : MEDICAL OFFICERS IN DISTRICT HOSPITALS
OF PERAK
DH Current Required WISN Workforce WISN Workload
number of number difference problem ratio pressure
MO (WISN)
A 8 7 +1 Surplus 1.14 None
B 6 8 -2 Shortage 0.75 High
C 10 7 +3 Surplus 1.43 None
D 11 11 0 Balance 1.0 Normal