Non-Value-Added Time: The Million Dollar Nursing Opportunity

The dual crises of high healthcare costs and the nursing shortage require a better understanding of inpatient nursing unit activities and, more specifically, their costs and the drivers of inefficiencies. This includes knowing not only how staff spend their time but also how much of this time is non-value-added (NVA) because wasted time leads to both high costs and nurse dissatisfaction. The authors discuss a study that determined the NVA time and costs of acute care nursing unit staff, identified drivers of high-cost NVA time, and compared activities and costs by type of nursing unit. These data have considerable implications for developing efficient and effective nursing care delivery models and for implementing process improvement and staff satisfaction initiatives.

[1]  C. Easley,et al.  Analysis and management of home health nursing caseloads and workloads. , 1997, The Journal of nursing administration.

[2]  Coleen Saylor,et al.  Work Environmental Factors and Retention of Nurses , 2005, Journal of nursing care quality.

[3]  D. McNeese-Smith,et al.  A content analysis of staff nurse descriptions of job satisfaction and dissatisfaction. , 1999, Journal of advanced nursing.

[4]  Anita L. Tucker,et al.  Operational failures and interruptions in hospital nursing. , 2006, Health services research.

[5]  L. Aiken,et al.  Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. , 2002, JAMA.

[6]  J. Geiger-Brown,et al.  Nurses' Perception of Their Work Environment, Health, and Well-Being , 2004, AAOHN journal : official journal of the American Association of Occupational Health Nurses.

[7]  B. Gajewski,et al.  The Relationship of Nursing Workforce Characteristics to Patient Outcomes , 2007, OJIN: The Online Journal of Issues in Nursing.

[8]  A. Hendrich,et al.  Intra-unit patient transports: time, motion, and cost impact on hospital efficiency. , 2005, Nursing economic$.

[9]  Ann Hendrich,et al.  A 36-hospital time and motion study: how do medical-surgical nurses spend their time? , 2008, The Permanente journal.

[10]  B. Mohr,et al.  Enhancing Patient Safety: Improving the Patient Handoff Process Through Appreciative Inquiry , 2007, The Journal of nursing administration.

[11]  Osei Omoike,et al.  The Balancing Act: Patient Care Time Versus Cost , 2008, The Journal of nursing administration.

[12]  S. Hagen,et al.  The relationship between UK hospital nurse staffing and emotional exhaustion and job dissatisfaction. , 2005, Journal of nursing management.

[13]  Amy B. Henley,et al.  The Balancing Act—: At Work and At Home , 2004 .

[14]  R. Kaplan,et al.  Time-driven activity-based costing. , 2003, Harvard business review.

[15]  J. Storfjell,et al.  Bridging the gap between finance and clinical operations with activity-based cost management. , 1996, The Journal of nursing administration.

[16]  Mahesh Gupta,et al.  Activity-Based Costing/Management and Its Implications for Operations Management , 2003 .