Balance Nursing Teams (BNUT): A Computerized Decision Support Instrument for organizing care teams.

The nursing shortage is an international phenomenon with wide-reaching implications for healthcare. The WHO estimated a 7.6 million shortfall in nurses by 2030. Attracting and, most importantly, retaining nurses is a global challenge. In Belgium, there is a chronic shortage in nurses and allied staff throughout all healthcare sectors. Moreover, because patient care is becoming more complex, there is an increasing need for sufficient, qualified and well-trained staff that can be assigned in changing environments. Policy makers are addressing the need for qualified staff by increasing the numbers of nurses entering the workplace. However, increasing the supply of nurses is insufficient to address the current staffing problems in healthcare. Organisations should also focus on methods to retain experienced personnel. However, organisations are not always well equipped to estimate if care teams are working optimally. To estimate the ideal composition of care teams, organisations apply patient assessment systems estimating acuity and care needs. However, these systems lack contextual information and need adjustment by management to be used for staff deployment. Because of the pressing shortage in nurses, organisations search for an optimal allocation of nurses across care teams. It is known that nurses sometimes are undertaking work that could be done by other caretakers. However, an optimal proportion of highly educated nurses is essential to provide high-quality care. It seems very difficult to acquire an optimally composed care team aiming for retention of staff and ensuring the quality of care. A report by the department of health by the Irish government recommended the development of software package using an evidence-based approach to assist in decisions on nurse staffing and skill-mix. The Chief Nursing Officers workgroup of Zorgnet-Icuro, a Flemish member organisation including 94 hospitals and 332 nursing homes, identified a strong need for the development of a standardised method to objectively allocate nurses and other care professionals to care teams taking into account the assigned governmental budget (Flemish and/or Federal). The project aim is to develop and study a computerised decision support instrument (CDSI), Balance Nursing Teams or BNUT, as a proof of concept, to support decisions concerning the allocation, monitoring and benchmarking of nursing care composition including numbers, qualification and competencies (skill mix) as well as additional roles related to care demands. The project is focussed on nursing care teams in acute care and psychiatric hospital as well as long-term facilities and primary care. BNUT discriminates and predicts the balance of care teams, in a continuum from negative imbalance, balance to positive imbalance, between supply and organisation of human resources including their capacity, efficiency and reliability and patient care needs and demands. During a conceptual phase of 10 months, the CDSI BNUT will be developed to Technology Readiness Level 4 (June 2020) and was financed externally. In the next phase, which will last 18 months (proof of concept A), BNUT will be developed further to implement in practice aiming for Technology Readiness Level 7 and operating at a pre-commercial scale guided by an internal and external technological and scientific validation process. In addition, the CDSI will be integrated as a Software as a Service (SaaS) product in order to assure the provision and dissemination in Belgian healthcare services. Lastly, BNUT will be prepared for full commercial international application reaching Technological Readiness Level 9.

Keywords:COMPUTERIZED DECISION SUPPORT INSTRUMENT

Disciplines:Other medical and health sciences not elsewhere classified

Project type:Collaboration project