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Defining staffing shortages for advanced practice providers (APPs) based on historical patterns of supplementary temporary worker utilization can produce inaccurate estimates. We have identified three possible sources of error: 1) relying on prior average levels of utilization without considering variance, 2) wrongly classifying individuals with different roles within a single category, and 3) assuming parttime positions of the apt size are available. Strategies, such as a central staffing model in which APPs can be trained and credentialed for multiple units, offering flexible part-time positions, and defining the costs and benefits of overstaffing and understaffing to determine the correct balance between the two, can address these issues.
Among the most critical elements in maintaining highquality health care delivery is appropriate staffing: namely having enough skilled workers to meet all institutional needs (Needleman, 2015). Appropriate staffing directly influences the quality of patient care, worker satisfaction, and the financial health of an organization (Mensik & Nickitas, 2015). Staffing challenges are particularly acute in specialized roles, such as advanced practice providers (APPs), a role that includes nurse practitioners, physician assistants, and certified nurse anesthetists, among others.
At our institution:
APPs work in a variety of settings across the entire organization, including the intensive care units, inpatient medical and surgical units, operating rooms, emergency department, all outpatient subspecialty clinics in the Care Network, includingprimary care, urgent care, and specialty care centers. (Childrens Hospital of Philadelphia, n.d.)
Precisely because APPs provide such diverse specialized services, the problem of accurately gauging overall institutional needs based on individual unit staffing requirements is difficult.
For a particular unit, a simple method of estimating an APP staffing shortage is to examine how many work-hours were provided by supplementary temporary workers in the past year. In the base case, if a unit regularly requires one supplementary temporary worker every pay period, it indicates a deficit of one staff member. It maybe tempting to generalize from that and estimate system-wide staffing shortages by examining the total annual hours worked by supplementary temporary workers (Engelbrecht et al., 2020). The annual total number of hours divided by 2,080, the annual time contribution of a full-time equivalent (ETE) employee, can provide an overall estimate of the average ETE staffing shortage for the institution.
We propose this simple measure as...