Evaluating palliative care ward staffing using bed occupancy, patient dependency, staff activity, service quality and cost data.
BACKGROUND
Palliative care staffing has remained unchallenged for decades while service provision has changed markedly, bringing new workforce demands. There is little evidence to inform hospice workforce structures, which strive to deliver the highest-quality holistic care.


OBJECTIVE
The study had three main aims, to: (i) adapt the acuity-quality workforce planning method used extensively in the UK National Health Service (NHS) for use in hospices; (ii) compare hospice and NHS palliative care staffing establishments and their implications; and (iii) create ward staffing benchmarks and formulae for hospice managers.


METHODS
A method adapted from a widely used nursing workforce planning and development (WP&D) study was used to collect data in hospice and palliative care wards.


METHODS
Twenty-three palliative care and hospice wards, geographically representing England, were studied.


RESULTS
A dataset, which profiles and benchmarks hospice and NHS palliative care ward occupancy, patient dependency, staff activity, ward establishments, quality and costs in 23 palliative care and hospice wards has been created. The database reveals large differences between hospice and palliative care wards. For example, hospice wards are better staffed and more expensive to run but staff deliver higher-quality care (measured using an established service quality audit) despite facing heavier workloads. Consequently, staffing multipliers are created to help managers estimate workload-based ward staffing.


CONCLUSIONS
This dataset provides evidence-based recommendations to inform palliative care nursing workforce modelling, including deciding future nursing workforce size and mix based on rising workloads. The new dataset is suitable for use in UK hospice wards and may be appropriate for future international use.
St. Ann's Hospice, UK. droberts@sah.org.uk
Dai
D
Roberts
Keith
K
Hurst
D001509:Bed Occupancy / Q000706:statistics & numerical data*; D019985:Benchmarking; D017048:Health Care Costs; D017051:Hospice Care / Q000191:economics / Q000458:organization & administration; D006801:Humans; D009740:Nursing Staff / Q000191:economics / Q000458:organization & administration*; D010166:Palliative Care / Q000191:economics / Q000458:organization & administration; D010561:Personnel Staffing and Scheduling / Q000592:standards*; D011787:Quality of Health Care / Q000592:standards*; D013222:State Medicine; D006113:United Kingdom; D000078329:Workforce; D016526:Workload / Q000191:economics / Q000706:statistics & numerical data