SLRH

CC #

6010

Current State thru FY2012 PP12

CC Name

ICU

6179

MSP

6385

MCH

7010

7083

7400

7420

7720

8720

ED

Urgent Care

Labor & Delivery

Patient Type

UOS

M/S ICU Patients Patient Days

FY2012
Budgeted
ADC from
Matrix or from
Flex Budget

5.00

FY2012
Actual ADC
thru PP12

4.77

FY2012
Budgeted
WH/UOS
Variable from
Matrix or from
Flex Budget
(w/o mgmt)

19.20

FY2012
Actual
Variable
WH/UOS
PP12
(w/o Mgmt)

20.67

OT/DOT

FY2012
Productivity
% thru PP12

89.70%

Actual OT%
FY2012 thru
PP15

2.80%

Actual DOT%
FY2012 thru
PP15

2.56%

Actual OT%
FY2011 thru
PP26

1.57%

Premier Recommended Changes

Premier
Actual DOT%
Proposed
FY2011 thru
OT% for FY
PP26
2013 Budget

0.97%

3.00%

Premier
Proposed
DOT% for FY
2013 Budget

1.00%

Premier
Proposed
Increase /(Decrease) in Change to FY RN:Patient
FTEs or Skill Mix
2013 WH/UOS Mandated
Ratio
Change for FY2013
(w/o mgmt)

Increase of 1.0 FTE UC

and 0.5 data tech and
0.25 Edu RN

Patient Days

27.00

27.87

10.22

10.32

99.20%

1.85%

0.43%

1.62%

0.23%

2.00%

0.50%

Couplets/
Antepartum// GYN Patient Days

0.00

8.79

7.33

6.36

115.70%

2.53%

0.69%

1.60%

1.03%

2.50%

1.00%

Transfer 0.5 FTE

Educator to Admin CC
and add 0.5 FTE RN OP
Infusion coverage
Decrease of 2 UC
evening hours;
correction

1.00%

Increase to include 0.5

FTE tech and 0.25 Edu
RN

Med/Surg/Tele/
Peds

Emergent/
Urgent

Urgent Care
Triage/Labor/
Delivery/
Recovery

Surgery and Recovery

Services
Surgical Patients

Visits

Visits

Deliveries

Surgical
Case
Minutes

Respiratory Therapy

Pulmonary
Patients

Adj. Patient
Days

Nursing Admin

Pulmonary
Patients

Adj. Patient
Days

67.17

16.64

2.07

749

36.70

Fixed

69.80

2.33

2.17

105.60%

6.76%

15.29

0.61
with mgmt

0.80
with mgmt

82.60%

11.44%

1.99

34.48
with mgmt

32.31
with mgmt

106.70%

4.16%

667

37.55

Fixed

Source: FY2011 Budget WH/UOS from Director-approved revised staffing matrices dated 2-23-201
Source: FY2012 Actuals thru PP12 from Bi-Weekly Payroll Report PP #12, ending December 3, 2011
Source: Premier Median OT% is 3%; Premier Quartile is 2.1%

.1166
with mgmt

1.94
with mgmt

Fixed

.1157
with mgmt

1.77
with mgmt

Fixed

101.80%

109.00%

96.80%

1.73%

1.46%

0.90%

1.46%

2.16%

2.40%

0.06%

1.38%

0.31%

2.15%

0.95%

4.00%

4.96%

0.11%

5.50%

1.00%

0.00%

0.00%

4.50%

1.50%

2.53%

1.10%

0.58%

0.05%

1.31%

0.45%

2.00%

1.50%

1.00%

No

Staffs to
Mandated
Ratio
(Yes / No)

Adequate
Break Relief
(Yes / No)

Sitter
Coverage
(Yes / No)

Matrix or
WH/UOS
Changes
from
FY2012
(Yes / No)

Changes/Recommendations
Changes to FY2012 WH/UOS for FY2013 to add UC coverage at an ADC of
5; criteria for 1:1s are in development; had been staffing a Resource
Nurse when there were 4 nurses including the CN - this was incorrect
according to the grid which indicated a Resource Nurse when there were
5 nurses in ratio; work with HR to develop an implementation plan to
follow the matrix related to Resource Nurses; requested to staff the UC
(10A - 6:30P, M-F) at an ADC of 5 rather than 8 so that the UC could cover
the desk and free the CN to give breaks

24.71

1:2

Yes

Yes

No

Yes

0.34

Yes

Yes

Rarely Use
Sitters

Yes

9.33

1:4-5
1:3-4
Couplets; 1:5
GYN

Yes

Yes

No

No

transfer educator rn to the education cost center, add admin position to

matrix, add 4 hours per day mon - fri for op infusion services, and reduce
nursing assitants to a 1:9 ratio instead of a 1:7 ratio in the matrix
minor change to FY2012 WH/UOS for FY2013 reduced 2 evening shift UC
hours to 0; currently working below budgeted WH/UOS due to vacancies; see
comments under L&D for action plan

2.45

1:4

Yes

Yes

No

No

Increase to FY2012 WH/UOS in FY2013 to account for data tech and

Education RN shared w/ ICU; all vacancies are now filled had lost 30% of staff
after conversion to 8-hr shifts; should see a decrease in Premium Pay now

Fixed

N/A

N/A

N/A

No

Yes

Urgent Care is open from 3P-11P, M-F, and from 11A-7P on Saturdays and
Sundays; staffed with an MD, MA, Rad Tech; make this a FIXED
department as this will always be the staffing regardless of volume;
OT/DOT came down to an average of 4.49% OT and 3.69% DOT for the
last 5 PPs of this fiscal year

36.00

1:1-2

Yes

Yes

No

No

conversion to 8-hr shifts in May 2011 resulted in vacancies; vacancies now

filled, but 4 FTEs in orientation until March 2012

Increase to FY2012 WH/UOS target for FHY2013 0.5 FTE for SIS/ARCIS
and 0.5 FTE for PAT clinic previously recorded as non-prod orientation
hours; Reduction of Edu target to 4%. Surgery has been able to reduce
the number of RNs on call since L&D is now providing the RN circulating
nurse on C-Sections; therefore, the amount of on-call dollars can be
reduced by approximately $85,000

0.10%

Reduce "on call" by

$85K; Increase .5 FTE
for PAT clinic and 0.5
FTE for SIS/ARCIS
previously recorded as
non-prod orientation
hrs

.1258
with mgmt

Yes

Yes

Yes

N/A

Yes

1.25%

Reduce budget by 1.0

FTE RT to offset other
nursing increases

1.7749 w/
mgmt

N/A

N/A

Yes

N/A

Yes

Consistently runs 1.0 FTE under budget; therefore, decrease by 1.0 fte to
offset increases in ICU

Yes

increased fixed target to account for backfilling pto hours when staff is
on pto

0.20%

No

Fixed

N/A

N/A

N/A

N/A

Staffing Matrix
ICU
6010
Please extend Census range to 125% of maximum census to allow for acuity adjustment. Matrix must be based on Medium Acuity patient. Do not build in any acuity adjustment. Matrix is to be built to
budget.

Shift:
Census
1
2
3
4
5
6
7
8
9
10

Day Shift - 7 Days

CN
8
8
8
8
8
8
8
8
8
8

RN
8
8
16
16
24
24
32
32
40
40

Break RN
4
4
8
8
8
8
8
8
8
8

UC
0
0
0
0
0
0
0
0
0
0

Edu RN
0
0
0
0
0
0
0
0
0
0

Evening Shift - 7 Days

Data Tech
2.86
2.86
2.86
2.86
2.86
2.86
2.86
2.86
2.86
2.86

Dir
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71

CN
8
8
8
8
8
8
8
8
8
8

RN
8
8
16
16
24
24
32
32
40
40

Break RN
4
4
8
8
8
8
8
8
8
8

Total

Night Shift - 7 Days

UC
0
0
0
0
0
0
0
0
0
0

CN
8
8
8
8
8
8
8
8
8
8

FY2016
8-bed ICU
RN:Patient ratio of 1:2; rarely have 1:1 patients
Charge Nurse cannot provide break relief for census 1-2 because cannot leave one nurse alone in the ICU in case of emergency- need minimal break relief

Break RN increased in 2012 in all departments r/t grievance in MedSurg that Charge nurses being used for break relief violated Appendix E in
contract "SLRH shall exercise good faith efforts to avoid patient assignments to charge nurses" - union argued covering breaks is assuming an
assignment. HR agreed to avoid penalty pay for the years previous when charge nurses were covering breaks after language in contract
Clerk RIF 07/15
Education RN not being used- hours eliminated
All staff work 8-hour shifts
Sitters are rarely used
Cardioversions are performed in this unit, approximately 5-8/month, each patient on unit 4-6 hours
Recover patients when the PACU is closed - even if the patient is not going to ICU

ICU 6010 (8 Hr)

RN
8
8
16
16
24
24
32
32
40
40

Break RN
4
4
8
8
8
8
8
8
8
8

UC
0
0
0
0
0
0
0
0
0
0

69
69
105
105
129
129
153
153
177
177

WHPUOS
w/ Mmgt
68.5671
34.2836
34.8557
26.1418
25.7134
21.4279
21.7953
19.0709
19.6186
17.6567

WHPUOS
w/o Mgmt
62.8571
31.4286
32.9524
24.7143
24.5714
20.4762
20.9796
18.3571
18.9841
17.0857

Staffing Matrix
ED

7010

Please extend Census range to 125% of maximum census to allow for acuity adjustment. Matrix must be based on Medium Acuity patient. Do not build in any acuity adjustment. Matrix is to be built to budget.

Census
40
70
150

Evening Shift - 7 Days

Day Shift - 7 Days

Shift:
CN
8
8
8

ED RNs
16
40
98

UC
8
8
16

Bill Hold
5.71
5.71
11.43

Edu RN
1.43
1.43
1.43

Data Tech
2.86
2.86
2.86

Admin
0.57
0.57
0.57

Stroke
3.42
3.42
3.42

Dir
5.71
5.71
5.71

CN
8
8
8

FY2016
Assumes weekday and weekend are staffed the same
ED nurse to patient ratio is 1:4
Charge Nurse provides Break Relief only when census demands- Resource nurse covers most breaks
Stroke program never budgeted - 3 days/week to ensure data collection and clinical practice guidelines followed
ADC in last fiscal year=
ADC increase by 12-15% in last three years - brought in more staff to allow for two nurse triage to reduce wait times
AA+ administrative clerical support for data collection for mandated reports 4 hours/week
All staff work 8-hour shifts
Edu RN has mgmt classification 0000 in payroll

ED 7010 (8 Hr)

ED RNs
18
40
104

UC
8
8
16

Night Shift - 7 Days

CN
8
8
8

ED RNs
16
24
72

WHPUOS w/
Mgmt

Total
UC
8
8
16

118
172
371

2.9426
2.4529
2.4761

S w/o
Mgmt
2.7999
2.3509
2.4381

Staffing Matrix
SLRH
7400
Please extend census range to 125% of maximum census to allow for acuity adjustment. Matrix must be based on Medium Acuity patient. Do not build in any acuity adjustment. Matrix is to be
built to budget

Day Shift
Census
1
2
3
4
5
6
7
8

RN
16
16
16
24
24
32
32
40

CN
4
4
4
4
4
4
4
4

Resource
RN
0
4
4
4
4
4
4
4

Evening Shift
UC
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00

DIR
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71

RN
16
16
16
24
24
32
32
40

CN
4
4
4
4
4
4
4
4

Resource
RN
0
4
4
4
4
4
4
4

FY2013
Assumes Weekday/Weekend staffing are the same
WH/UOS with management

2
38.86

ADC
HPPD

Total
Hours

Night Shift
OB TECH
0
0
0
0
0
0
0
0

RN
16
16
16
24
24
32
32
40

CN
4
4
4
4
4
4
4
4

Resource
RN
0
4
4
4
4
4
4
4

66
78
78
102
102
126
126
150

WHPUOS
w/Mgmt

65.7100
38.8550
25.9033
25.4275
20.3420
20.9517
17.9586
18.7138

WHPUOS
w/o Mgmt

71.4243
36.0000
27.8081
26.8561
21.4849
21.9040
18.7749
19.4280

Staffing Matrix
MSP
6179
Please extend Census range to 125% of maximum census to allow for acuity adjustment. Matrix must be based on Medium Acuity patient. Do not build in any acuity adjustment. Matrix is to be built to budget.

Day Shift - 7 Days

Shift:

Census
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46

CN
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8

RN
16
16
24
24
24
24
32
32
32
32
32
40
40
40
40
40
48
48
48
48
48
56
56
56
56
56
64
64
64
64
72
72
72
72
72
80
80
80
80

Resource
RN
0
0
0
0
0
0
0
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
16
16
16
16
16
16
16
16
16
16
16
16
16

NA
0
0
0
0
8
8
8
8
16
16
16
16
16
16
16
16
16
24
24
24
24
24
24
24
24
24
24
32
32
32
32
32
32
32
32
32
32
40
40

Evening Shift - 7 Days

Clerk
0
0
0
0
0
0
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8

Admin
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71

DIR
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71
5.71

C
N
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8

RN
16
16
24
24
24
24
32
32
32
32
32
40
40
40
40
40
48
48
48
48
48
56
56
56
56
56
64
64
64
64
72
72
72
72
72
80
80
80
80

Resource
RN
0
0
0
0
0
0
0
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
16
16
16
16
16
16
16
16
16
16
16
16
16

FY2016
Break RN increased in 2013/14 r/t grievance with union.
Combination of Med/Surg (1:5), Tele (1:4), and Pedi (1:4) patients
All staff work 8-hour shifts; Sitters are rarely used
Aide matrix reduced 2014 in response to productivity <100%, primarily related to low volume
Assumes weedkays and weekends are staffed the same
OP Infusions, M-F, approximately 2 per day; range of 2-8 hours/patient depending upon the infusion; add 4 hrs/day for RN Infusion RN
4 hrs/day added fo an OP Infusion to cover this volume in FY2013

MSP 6179 (8 Hr)

NA
0
0
0
0
8
8
8
8
8
8
8
8
8
16
16
16
16
16
16
16
16
16
16
24
24
24
24
24
24
24
24
24
24
24
24
24
32
32
32

Night Shift - 7 Days

Clerk
0
0
0
0
0
0
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8

C
N
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8

RN
16
16
24
24
24
24
32
32
32
32
32
40
40
40
40
40
48
48
48
48
48
56
56
56
56
56
64
64
64
64
72
72
72
72
72
80
80
80
80

Resource
RN
0
0
0
0
0
0
0
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
16
16
16
16
16
16
16
16
16
16
16
16
16

Total

NA
0
0
0
0
0
0
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8

83
83
107
107
123
123
171
195
203
203
203
227
227
235
235
235
259
267
267
267
267
291
291
299
299
299
347
355
355
355
379
379
379
379
379
403
411
419
419

WHPUO
S w/
WHPUOS
Mmgt
w/o Mgmt

10.4275
9.2689
10.7420
9.7655
10.2850
9.4938
12.2443
13.0280
12.7138
11.9659
11.3011
11.9695
11.3710
11.2105
10.7009
10.2357
10.8092
10.6968
10.2854
9.9044
9.5507
10.0490
9.7140
9.6587
9.3569
9.0733
10.2182
10.1549
9.8728
9.6059
9.9847
9.7287
9.4855
9.2541
9.0338
9.3819
9.3505
9.3204
9.1178

9.7138
8.6344
10.1710
9.2464
9.8092
9.0546
11.8364
12.6473
12.3569
11.6300
10.9839
11.6689
11.0855
10.9386
10.4414
9.9874
10.5713
10.4684
10.0658
9.6930
9.3468
9.8521
9.5237
9.4745
9.1784
8.9003
10.0503
9.9917
9.7142
9.4516
9.8345
9.5823
9.3428
9.1149
8.8979
9.2491
9.2207
9.1936
8.9937

WHPUOS
w/o Mgmt

1.3034
1.0299
1.0742
0.8878
0.8571
0.7303
0.8746
0.8685
0.7946
0.7039
0.6278
0.6300
0.5686
0.5338
0.4864
0.4450
0.4504
0.4279
0.3956
0.3668
0.3411
0.3465
0.3238
0.3116
0.2924
0.2749
0.3005
0.2901
0.2742
0.2596
0.2628
0.2495
0.2371
0.2257
0.2151
0.2182
0.2125
0.2071
0.1982

Staffing Matrix
MCH
6385
Please extend Census range to 125% of maximum census to allow for acuity adjustment. Matrix must be based on Medium Acuity patient. Do not build in
any acuity adjustment. Matrix is to be built to budget.

Day Shift - 7 Days

Shift:
Census
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25

CN Labor
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4

RN/ M/B
8
8
8
16
16
16
16
16
24
24
24
24
32
32
32
32
40
40
40
40
48
48
48
48
48

Resource RN

Evening Shift - 7 Days

Clerk
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0.00

CN Labor
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4

RN M/B
8
8
8
16
16
16
16
16
24
24
24
24
32
32
32
32
40
40
40
40
48
48
48
48
48

Resource RN

FY2013
Combination of Mother/Baby, and Newborn Nursery
Mother/Baby Couplets are 1:4
Charge Nurse provides Break Relief
All staff work 8-hour shifts; Sitters are not used
Assumes weedkays and weekends are staffed the same

MCH 6385 (8 Hr)

Night Shift - 7 Days

CN Labor
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4

RN/ M/B
8
8
8
16
16
16
16
16
24
24
24
24
32
32
32
32
40
40
40
40
48
48
48
48
48

Total

WHPUOS

Resource RN
36
36
36
60
60
60
60
60
84
84
84
84
108
108
108
108
132
132
132
132
156
156
156
156
156

36.0000
18.0000
12.0000
15.0000
12.0000
10.0000
8.5714
7.5000
9.3333
8.4000
7.6364
7.0000
8.3077
7.7143
7.2000
6.7500
7.7647
7.3333
6.9474
6.6000
7.4286
7.0909
6.7826
6.5000
6.2400