Long-Term Care Survey Alert

Sometimes the staffing numbers aren't the real issue, says expert.

Your facility suddenly has a spike in falls or pressure ulcers, but does it really need more staff to tackle the problem?

Scenario: Suppose you have a problem on a particular shift with falls, says Rena Shephard, RN, RAC -MT, C-NE, MHA. "The DON and his or her team should first look at the staffing patterns and designs of various positions to see if the problem could be resolved by redistributing staff," she says. Or perhaps you may even need to rewrite some of the job descriptions or redesign positions, Shephard adds. Examples might include using a primary assignment model or assigning someone to do risk management.

Also conduct "a comprehensive analysis of how staff is deployed in the area with the falls," Shephard suggests. Find out what's going on in the unit during that time of the day that requires more staffing time, which means more staff might be needed at that time, she advises.

Key point: "You may find that one area doesn't really need as much staff whereas another area needs more -- or staff of a particular type," Shephard relays. Also keep management involved as you conduct your analysis "so that by the time you go to them, the evidence is really there that the facility does not have enough staff  if that, in fact, is the final conclusion," says Shephard, president and CEO of RRS Healthcare Consulting Services in San Diego.