Subjective Work Measurement for Nurse Staffing

Human Engineering can be viewed as a method of achieving “optimal” output from a man-machine system by engineering the requisites for achieving output to the constraints imposed by the human component. Operations Research is concerned with the “optimal” allocation of resources. When the resource becomes some property of human beings, difficulty is encountered in the measurement of human attributes over which optimization is to take place. This paper describes a staffing methodology which attempts to “optimize” personnel utilization in job performance in terms of the workload, the objective being to minimize worklod while maintaining performance and quality. The methodology is differentiated from time based methodologies in that it employe a technique called constant sum paired comparisons to establish subjective measures of workload. This subjective technique has its origins in the psychophysical methods previously applied in Human Engineering. This subjective technique allows perceptions of workload to include not only the time required for activity performance but also the individuality of the worker, his concept of work scope, responsiblity, and methods used, conditions of the working environment and the individuality of the work required. An application to the staffing of nursing units in acute adult hospitals is presented where staffing recommendations specific to each unit and shift (working situation) and which reflect the distribution and census of patients, capacities of nursing personnel, and goals for care delivery in terms of skill levels and quality of care are computed.