Cost Drivers for Nursing
Services
Clinical leaders at the point of
service are needed around the world
to be full partners in redesigning
health care. With a basic understanding
of hospital revenues and
expenses, these nurses are knowledgeable
about the cost of patient
care and sources of revenue that pay
for nursing services. As a result, they
can make meaningful suggestions
for transforming patient care (CMS,
2013; Nichols & O’Malley, 2006;
Quizlet.com, 2014).
Clinical leaders at the bedside are
aware of the major components of a
hospital’s budget and can identify
where the cost of nursing services
fits. They are also aware of the four
key drivers of nursing care costs:
staffing, workload, workflow, and
work activities. These leaders can
advocate for safe staffing practices
because they know patient volume,
acuity, skill mix, practice model,
and productive vs. nonproductive
hours should be considered in
determining unit staffing and
staffing patterns. They participate
in determining workload because
they recognize the effect of nurse
workload on service quality.
Clinical leaders take action to assure
efficiency in workflow processes so
nurse time and energy are saved
and the delivery of quality patient
care is ensured. They are also aware
of the effect of direct (patient care)
and indirect (e.g., change of shift
reports, justification of the scheduled
drug count, committee meetings)
nurse activities on the cost of
nursing services. Finally, these leaders
recognize the importance of the
balance between productivity and
quality of services, and its influence
on the cost of nursing services. In
essence, nurse leaders can integrate
knowledge related to the cost of
nursing services into work redesign,
safe staffing projects, and more
(ANA, 2014a, 2014b, 2014c). [Rate
your knowledge about cost drivers for
nursing services.]