Project Summary

The Safe Staffing and Healthy Workplaces (SSHW) Unit’s goal is to have staffing and workplaces that provide quality patient care, quality work environments for staff and the best use of health resources. This is in recognition of the District Health Boards (DHBs) and the Health Unions joint commitment to advancing patient-centred improvements in service quality by ensuring safe staffing. The Unit was initially formed through a collaborative partnership between the New Zealand Nurses’ Organisation (NZNO) and the DHBs, in order to progress the recommendations in the 2006 Safe Staffing Committee of Inquiry report and is now collectively funded by all 20 DHBs.

The SSHW Unit has developed and facilitates the implementation of a programme called Care Capacity Demand Management (CCDM) on behalf of the DHBs and the Health Unions.

The project objective(s) was to replace the complex and error-prone Excel spreadsheet based systems of report analysis with an accurate, intuitive, easy-to-use application.

 

Challenges

One of the key components of the CCDM programme is a staffing methodology to support the right people in the right place at the right time in order to provide quality patient care. Two important components of this function are:

· The Work analysis: a detailed snapshot of the actual work carried out on a ward over a 2-week period, compiled by staff completing half-hourly work activity summaries, and end-of-shift surveys.

· A Full Time Equivalent (FTE) calculation for each ward.

The Work Analysis and FTE calculations were previously carried out using cumbersome, complicated Excel spreadsheets that are highly prone to human error. Each DHB had operated their own Excel sheets in silos, and efficiency was poor (eg. a 2 week work analysis project would typically take 4 months to analyze and compile a full report).

 

How the Project Helped

Having won a competitive tender process, Designertech set about creating one application that DHBs could use to run the work analysis and FTE calculation functions quickly and intuitively. Designertech brought an important competitive advantage to this project with their business knowledge of SSHW’s operations, and the ability to communicate that business knowledge directly to the software engineers. In creating the app for the SSHW Unit, Designertech chose to utilise a new tool kit (Angular JS/Single-page Application) which sped up the development cycle and provided an intuitive GUI and incorporates a business intelligence layer to enable users to easily interrogate the data. Innovation in this project was double-layered; the first layer of innovation being the way in which Designertech engaged with new technology (SPA), and layered above that is the innovation the client will gain from the new application; making staffing practice analysis and reporting significantly quicker, more accurate and increasingly efficient. A single cloud-based repository adds to the simplification.

 

“This is awesome, I wish we had it five years ago” - Nurse Manager

“Isn’t that just beautiful – it is so easy” - Business Analyst

“It is magic – just so straightforward” - CCDM Coordinator

“Really valuable as each DHB will be using the same way of calculating the data as we now have a consistent platform” - DHB Nurse Manager

“This will make my life so much easier” - DHB Decision Support Analyst

 

Results, Returns on Investment and Future Plans

The app is being rolled out across the DHBs, removing their dependence on time-consuming, complex, cumbersome, and error-prone Excel workbook methods. Lisa Skeet (Director of Safe Staffing Healthy Workplaces Unit) noted that “once the DHBs see how easy this software is to use, they’ll be able and willing to utilise it much more often” - transforming the work and “lowering the bar” for DHBs to do more studies more often – and enabling a better understanding of nursing workloads. Ultimately, the system will support improved care to patients through ensuring wards are staffed appropriately – deployed at the right times to the right places.

The new app is high on “cool factor”. Lisa Skeet says that the app is “exactly what we were looking for”, and drew many “wow” comments from staff during the unveiling and piloting of the software. It permits high-quality real time data to quickly and efficiently be produced to give DHBs faster, more accurate, and deeper insights into staffing requirements – allowing them to design optimal staff rosters that account for complex variances across wards, shifts, and seasons. Visual reporting (data charts) have become much richer; more charts are available to the DHBs, which are also easier to interpret and faster to compile than under the old Excel system.

A major “wow factor” of this project was the ability of Designertech to go beyond scope and provide features such as the “What If Scenario” capability of the app, which allows interactive engagement with the data at the click of a button. This enables future rosters to be forecast to a high level of accuracy simply by manipulating staffing variables on-screen, to receive outputs about what ratio of forecasted shifts will be “OK”, have staff deficits, or staff surpluses.

The Safe Staffing and Healthy Workplaces (SSHW) Unit now have a cool, innovative, intuitive application that can dramatically affect the pace, accuracy, and ease-of-use for their participating DHB’s to identify where staffing workloads can be changed/made more efficient.

The software has the potential to dramatically enhance the reputation of the SSHW Unit and the CCDM programme in the eyes of the District Health Boards throughout NZ, by showing that the Unit has delivered on its foundational objectives.

Designertech and the SSHW Unit benefitted from a fast-start to this project; made possible by the Designertech team’s competitive advantage of prior industry knowledge regarding the inherent challenges that the SSHW Unit faced using the old Excel-based approach to work analysis and FTE calculations. During the project, Designertech and the SSHW Unit established a strong, long-term relationship that has the potential to develop the application with new innovations and features. 

Lisa Skeet feels that the app developed by Designertech and SSHW Unit will ensure standardized staffing methodology and better staffing outcomes, which will ultimately translate into enhanced, and more consistent care levels for patients within New Zealand hospitals.

 

More recent data has shown that the implementation of CCDM has has led to a $1 million boost in nursing staff (Source Nursing Review, November 2017)

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