All providers are required to report on safe staffing and post-Francis, this is everyone’s responsibility.
Preparing these reports can be hard work. There remains little guidance on format and content, and analysing the data consumes senior staff time. The result is huge variation in how and what each provider reports to their Board and to the public.
At the push of a button, Establishment Genie provides standardised, comprehensive reports and addresses this need.
- Staffing metrics: Skillmix, Beds per Nurse or Midwife, WTE per bed and Care Hours per Bed Day. We break these down across the week and by patient type, to avoid blunt averages that hide peaks, troughs and risks.
- Supervisory and management time of senior ward staff.
- Supporting and specialist roles on the ward – from Discharge Coordinators to Ward Clerks.
- The exact ‘uplift’ (or ‘headroom’) that each role on the ward needs.
- The hours and WTE required of all roles on the ward, compared to what the current budget provides, with analysis and costing of any difference between the two.
- A ready reckoner for the additional staffing needed by any escalation beds on the ward, should they open.
- The ward’s use of bank, agency and 1:1 specialling.
- Guidance on managing leave in order to keep within the uplift.
- The predicted cover needed for staff on maternity/paternity/adoption leave, based on the average for the trust.
- Ward information items – there’s a huge choice of what can be entered to the system in outcomes for patients (e.g. from the safety thermometer), staff (e.g. vacancy and turnover) and operational outcomes (e.g. delayed transfers). We add to these choices based on feedback.
The Ward Report provides summary and detailed information on a specific ward, with definitions and commentary. There is the option to apply local or national guidelines to the outputs (e.g. 65% registered Skillmix – RCN, 2006), and any that do not meet the desired standard are highlighted. This can be useful for understanding any variations in planned care levels throughout the week – and prompting a remodel of the staffing if this causes concern.
The Ward Report will present either the Current or Proposed staffing model for the ward. Typically, all wards will have a Current Ward Report, but some may also have a Proposed Ward Report if the trust has explored alternative options for staffing the ward, e.g. in reaction to issues uncovered in the Current Ward Report, in response to a CQC inspection, to model the effect of the proposed Nursing Associate role, etc.
Existing users of the Genie have identified setting bespoke study leave allowances per ward, standardising supervisory time across the week, and costing for unfunded beds as reasons to make a Proposed template and assess what this means for care levels and the WTE requirement.
The Group Report shows how a selection of wards in a trust compare with each other on a chosen metric, e.g. Nurse to Bed Ratio on Weekend Nights, Difference between WTE Budget and WTE Requirement, etc. There is a choice of over 250 safety, budgetary and outcome metrics. We update this list centrally and we welcome requests to add items to support national policy and initiatives.
A second metric can be overlaid to see if there appears to be any correlation between two factors that might warrant further investigation. For example, is a trend indicated between the amount of Band 7 Supervisory Time and falls, staff retention, FFT scores, etc.
The Group Report can be used to identify and understand variation between wards, allowing trusts to address it where it is unwarranted and provide for it where it is justified. This has led to trusts reallocating Discharge Coordinator and Practice Educator time across groups of wards, standardising Supervisory and Management Time, and assessing whether the wards compare in the way they would expect. The Group Report can also be used to show the difference between the ‘as-is’ and ‘future-state’ of Current and Proposed staffing models.
In 2017 we plan to develop our Group Reporting even further, so that users of Establishment Genie can choose to compare their wards against an anonymised peer group of wards from other member trusts.