The trusted source for
healthcare information and
Gather data properly to study off-peak danger
Data gathering is key to reducing the risks associated with off-peak hours, says Patti Hamilton, PhD, RN, graduate studies at Midwestern State University in Wichita Falls, TX. But the data must be gathered and analyzed in a way that doesn't obscure the information about off-peak hours.
Most organizations aggregate data in such a way that the off-peak risks can be buried, she says.
"We look at the number of patients, hours, and staff; but we aggregate that over a month, so that it is reported as a monthly figure," she says. "Once you aggregate like that, you can no longer see if nights and weekends are a special problem."
That compilation also affects how nurses are staffed on different shifts, Hamilton explains. She says nurses have told her that even when they have the ability to call in more nurses for a particular shift with high acuity, the nurse manager is then compelled to make up for that higher number by decreasing staffing on another shift, so that the monthly numbers average out correctly.
"Even over a day, the averaging can be deceptive," she says. "When your average for the 24-hour period seems good, you may not realize that the numbers were higher during the day and much lower at night."
The averaging and aggregation often are done to "reduce the noise" in the data, the random ups and downs that have no significance when you're looking for the bigger picture, Hamilton says. But those ups and downs may not be random at all and could reveal the problems during off-peak hours.
"Reducing the noise reduces the information we can get out of this data," she says.