Front-line ordering clinicians: matching workforce to workload.
BACKGROUND
Matching workforce to workload is particularly important in healthcare delivery, where an excess of workload for the available workforce may negatively impact processes and outcomes of patient care and resident learning. Hospitals currently lack a means to measure and match dynamic workload and workforce factors.


OBJECTIVE
This article describes our work to develop and obtain consensus for use of an objective tool to dynamically match the front-line ordering clinician (FLOC) workforce to clinical workload in a variety of inpatient settings.


METHODS
We undertook development of a tool to represent hospital workload and workforce based on literature reviews, discussions with clinical leadership, and repeated validation sessions. We met with physicians and nurses from every clinical care area of our large, urban children's hospital at least twice.


RESULTS
We successfully created a tool in a matrix format that is objective and flexible and can be applied to a variety of settings. We presented the tool in 14 hospital divisions and received widespread acceptance among physician, nursing, and administrative leadership. The hospital uses the tool to identify gaps in FLOC coverage and guide staffing decisions.


CONCLUSIONS
Hospitals can better match workload to workforce if they can define and measure these elements. The Care Model Matrix is a flexible, objective tool that quantifies the multidimensional aspects of workload and workforce. The tool, which uses multiple variables that are easily modifiable, can be adapted to a variety of settings.
Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania and The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Evan S
ES
Fieldston
Lisa B
LB
Zaoutis
Patricia J
PJ
Hicks
Susan
S
Kolb
Erin
E
Sladek
Debra
D
Geiger
Paula M
PM
Agosto
Jan P
JP
Boswinkel
Louis M
LM
Bell
D003695:Delivery of Health Care / Q000379:methods / Q000592:standards / Q000639:trends*; D006280:Health Workforce / Q000592:standards / Q000639:trends*; D006801:Humans; D009741:Nursing Staff, Hospital / Q000592:standards / Q000639:trends*; D005791:Patient Care / Q000379:methods / Q000592:standards / Q000639:trends; D010561:Personnel Staffing and Scheduling / Q000639:trends*; D010820:Physicians / Q000592:standards / Q000639:trends*; D016526:Workload / Q000592:standards