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  1. Tierney, Shirley J. PhD, RN
  2. Seymour-Route, Paulette PhD, RN
  3. Crawford, Sybil PhD


OBJECTIVE: The aim of this study was to examine the effect of patient turnover and acuity on worked hours per patient day (WHPPD).


BACKGROUND: An examination of staffing plans publically posted by Massachusetts hospitals with more than 300 beds revealed that less than 40% were within 5% of their planned versus actual WHPPD.


METHODS: Three years of WHPPD data collected from 14 adult acute care units were correlated with patient turnover and acuity data. A weight factor was retrospectively added to 8 paired units' planned WHPPD where correlations were identified.


RESULTS: Twelve units (86%) showed significant correlations between WHPPD and patient turnover. Correlations between patient acuity and WHPPD were significant only at the aggregate level. After weighting WHPPD, the 8 paired units demonstrated a decreased variance between planned and actual WHPPD.


CONCLUSION: Using a weight factor added to WHPPD to right size acute care medical-surgical units may be useful for accurate staff planning and budgeting.