Generalizable items and modular structure for computerised physician staffing calculation on intensive care units

作     者：Manfred Weiss Gernot Marx Thomas Iber 

作者机构：Department of Anesthesiology University Hospital Ulm Klinik für Operative Intensivmedizin und Intermediate Care Uniklinik RWTH Aachen Department of Anesthesia and Intensive Care Klinikum Mittelbaden Baden-Baden/Bühl 

出 版 物：《World Journal of Critical Care Medicine》 (世界重症医学杂志)

年 卷 期：2017年第6卷第3期

页      面：153-163页

学科分类：1004[医学-公共卫生与预防医学(可授医学、理学学位)] 10[医学] 

基　　金：Supported by the German Association of Anaesthesiologists(BDA) the German Society of Anaesthesiology and Intensive Care Medicine(DGAI),in that BDA and DGAI sponsored meetings of the working group"personnel management"to create the physician staffing tools 2008 and 2012.Weiss M,Marx G and Iber T are members of the working group"personnel management of BDA and DGAI" 

主　　题：Budgets Critical care Economics Humans Intensive care units Personnel hospital Personnel staffing and scheduling Physicians Workload Quality of health care 

摘      要：Intensive care medicine remains one of the most costdriving areas within hospitals with high personnel costs. Under the scope of limited budgets and reimbursement, realistic needs are essential to justify personnel staffing. Unfortunately, all existing staffing models are top-down calculations with a high variability in results. We present a workload-oriented model, integrating quality of care, efficiency of processes, legal, educational, controlling, local, organisational and economic aspects. In our model, the physician s workload solely related to the intensive care unit depends on three tasks: Patient-oriented tasks, divided in basic tasks(performed in every patient) and additional tasks(necessary in patients with specific diagnostic and therapeutic requirements depending on their specific illness, only), and non patient-oriented tasks. All three tasks have to be taken into account for calculating the required number of physicians. The calculation tool further allows to determine minimal personnel staffing, distribution of calculated personnel demand regarding type of employee due to working hours per year, shift work or standby duty. This model was introduced and described first by the German Board of Anesthesiologists and the German Society ofAnesthesiology and Intensive Care Medicine in 2008 and since has been implemented and updated 2012 in Germany. The modular, flexible nature of the Excel-based calculation tool should allow adaption to the respective legal and organizational demands of different countries. After 8 years of experience with this calculation, we report the generalizable key aspects which may help physicians all around the world to justify realistic workload-oriented personnel staffing needs.