title: Developing Objective Metrics for Unit Staffing (DOMUS) study.
abstract: OBJECTIVE
  Safe midwifery staffing levels on delivery suites is a priority area for any maternity service. Escalation policies are tools that provide an operational response to emergency pressures. The aim of this study was to assess the feasibility of using a scoring system to contemporaneously assess the required staffing level based on demand and use this to determine delivery suite escalation level and utilise the information generated regarding clinical activity (Demand) and staffing levels (Capacity) to generate unit-specific calculation for the actual number of midwifery staff required.
  
  
  METHODS
  A maternity unit of a university-affiliated tertiary referral hospital.
  
  
  METHODS
  Over a 12-month period, specifically designed scoring sheets were completed by delivery suite shift co-ordinators four times a day (04:00, 10:00, 16:00 and 22:00). Based on the dependency score (Demand) and the number of midwifery staff available (Capacity), an escalation level was determined for each shift. The 80th centile of the demand was used to determine optimal capacity.
  
  
  RESULTS
  A total of 1160 scoring sheets were completed. Average staff number throughout the year on any shift was 7 (range 3-11). Average dependency score was 7 (range 1-14). The 80th centile for demand was calculated to be 11.
  
  
  CONCLUSIONS
  This study stresses the importance and usefulness of a simple tool that can be used to determine the level of escalation on delivery suite based on an objective scoring system and can also be used to determine the appropriate staffing on delivery suite.
authors.affiliation: University Hospital of North Staffordshire NHS Trust, Stoke, UK.
authors.forename: I
authors.initials: I
authors.lastname: Siddiqui
authors.affiliation: University Hospital of North Staffordshire NHS Trust, Stoke, UK.
authors.forename: B
authors.initials: B
authors.lastname: Whittingham
authors.affiliation: University Hospital of North Staffordshire NHS Trust, Stoke, UK.
authors.forename: K
authors.initials: K
authors.lastname: Meadowcroft
authors.affiliation: University Hospital of North Staffordshire NHS Trust, Stoke, UK.
authors.forename: M
authors.initials: M
authors.lastname: Richardson
authors.affiliation: University Hospital of North Staffordshire NHS Trust, Stoke, UK.
authors.forename: J C
authors.initials: JC
authors.lastname: Cooper
authors.affiliation: Department of Primary Care Sciences, Arthritis Research UK Primary Care Centre, Keele University, Staffordshire, Keele, UK.
authors.forename: J
authors.initials: J
authors.lastname: Belcher
authors.affiliation: Norfolk and Norwich University Hospital NHS Foundation Trust, Norwich, UK.
authors.forename: E
authors.initials: E
authors.lastname: Morris
authors.affiliation: College of Medical & Dental Sciences, Birmingham centre for Women's and Children's Health, School of Clinical & Experimental Medicine, University of Birmingham, Birmingham, UK Birmingham Women's NHS Foundation Trust, Birmingham, UK.
authors.forename: K M K
authors.initials: KM
authors.lastname: Ismail
mesh_terms: D003696:Delivery Rooms; D005240:Feasibility Studies; D006801:Humans; D008880:Midwifery; D010561:Personnel Staffing and Scheduling / Q000706:statistics & numerical data*; D000078329:Workforce
keywords: OBSTETRICS