title: Pre-implementation studies of a workforce planning tool for nurse staffing and human resource management in university hospitals.
abstract: OBJECTIVE
  To investigate the reliability, validity and feasibility of the RAFAELA workforce planning system (including the Oulu patient classification system - OPCq), before deciding on implementation in Dutch hospitals.
  
  
  BACKGROUND
  The complexity of care, budgetary restraints and demand for high-quality patient care have ignited the need for transparent hospital workforce planning.
  
  
  METHODS
  Nurses from 12 wards of two university hospitals were trained to test the reliability of the OPCq by investigating the absolute agreement of nursing care intensity (NCI) measurements among nurses. Validity was tested by assessing whether optimal NCI/nurse ratio, as calculated by a regression analysis in RAFAELA, was realistic. System feasibility was investigated through a questionnaire among all nurses involved.
  
  
  RESULTS
  Almost 67 000 NCI measurements were performed between December 2013 and June 2014. Agreement using the OPCq varied between 38% and 91%. For only 1 in 12 wards was the optimal NCI area calculated judged as valid. Although the majority of respondents was positive about the applicability and user-friendliness, RAFAELA was not accepted as useful workforce planning system.
  
  
  CONCLUSIONS
  Nurses' performance using the RAFAELA system did not warrant its implementation. Hospital managers should first focus on enlarging the readiness of nurses regarding the implementation of a workforce planning system.
authors: Departments of Surgery and Quality Assurance and Process Innovation, Academic Medical Centre (AMC), Amsterdam, the Netherlands.
authors: Catharina J
authors: CJ
authors: van Oostveen
authors: Department of Surgery, Academic Medical Centre (AMC), Amsterdam, the Netherlands.
authors: Dirk T
authors: DT
authors: Ubbink
authors: Department of Internal Medicine, Academic Medical Centre (AMC), Amsterdam, the Netherlands.
authors: Marian A
authors: MA
authors: Mens
authors: Department of Surgery, Free University VU Medical Centre (VUmc), Amsterdam, the Netherlands.
authors: Edwin A
authors: EA
authors: Pompe
authors: Department of Surgery, Academic Medical Centre (AMC) and Amsterdam School of Health Professionas (ASHP), Amsterdam University of Applied Sciences, Amsterdam, the Netherlands.
authors: Hester
authors: H
authors: Vermeulen
mesh_terms: D005240:Feasibility Studies; D006285:Health Planning / Q000458:organization & administration; D006785:Hospitals, University / Q000458:organization & administration*; D006801:Humans; D009426:Netherlands; D009741:Nursing Staff, Hospital / Q000458:organization & administration*; D010559:Personnel Management / Q000379:methods*; D010561:Personnel Staffing and Scheduling / Q000458:organization & administration; D058996:Quality Improvement / Q000458:organization & administration; D015203:Reproducibility of Results; D016526:Workload
keywords: nursing; nursing care intensity; patient classification system; personnel staffing and scheduling; workforce planning; workload