Nursing workload measurement as management information

K e y w o r d s : Health services, personel, measurement, scheduling 1 . I n t r o d u c t i o n A few years ago a system of budgetting was introduced in Dutch hospitals. The Dutch National Hospital Board and the National Consultants Union together published a declaration of intent regarding the budgetting situation. Some important points are: cost budgets and activities have to be completely matched, being the collective responsibility of medical staff and management; a medical plan contains the expected activities; a hospital plan contains an indication of costs (manpower, materials); each department makes its own plan of activities, based on the agreed production; total costs, and not total activities, are set to an absolute limit. * Current address: GITP Consultants, P.O. Box 9032, 6500 KC Nijmegen, Netherlands. Received July 1985 The department managers are responsible for their budgets, but they cannot influence all costs; only direct costs. So indirect costs and overheads are not considered here. Relevant costs are for required staff, for equipment and instruments, and for materials used. Of these, the required staff is the most complex to determine. From the cost point of view, staff is also very important, because it is the most expensive production factor in the hospital's operating costs. So it is essential for the management to have insight into staff requirements. Workload measurement systems help to give this insight. Does a workload measurement system by definition provide useful management information? It presumes to support the manager in taking his decisions, in this case decisions regarding the staffing process. The staffing process consists of several hierarchical levels. Each level has its own decision maker with specific competence to intervene, specific objectives and output, different time horizons and constraints. In my opinion, a management control system can only be successful as far as the inputs can be assigned. Output measure0377-2217/87/$3.50 © 1987, Elsevier Science Publishers B.V. (North-Holland) 200 G. de Vries / Nursing workload measurement as management information Organizational Activity