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Is the Workload Indicators of Staffing Needs (Wisn) Method Rigorous Enough to Tell Us How Many Nurses We Need in a General Hospital? Publisher



Niaraees Zavare AS1 ; Akbari F2 ; Zahmatkesh M3 ; Alizadeh Bazgir M2 ; Shaarbafchizadeh N2, 4
Authors
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Authors Affiliations
  1. 1. Department of Health Economics, School of Health Management & Information Sciences, Iran University of Medical Science, Tehran, Iran
  2. 2. Health Management and Economics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
  3. 3. Health Management Department of HRM and Organization Studies, Royal Holloway University of London, London, United Kingdom
  4. 4. Hospital Management Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran

Source: International Journal of Healthcare Management Published:2023


Abstract

This study aimed to evaluate the practical use of the Workload Indicators of Staffing Needs (WISN) method in a general hospital in Iran. This method was used to determine the staffing needs of nurses in various hospital units, and the study examined the gap between the theoretical calculations and the actual use of the data in the hospital. Data was collected through a mixed-method approach including observations, interviews, and document analysis. The results showed that the WISN method indicated a surplus of nursing staff and no work pressure on nurses. However, the method did not account for the complexity of nurses managing multiple tasks simultaneously, and the low bed occupancy and low hospital revenue raised concerns about the excess of nurses obtained by the WISN method. The study suggests that decision-making on staff arrangements should not be solely based on WISN's numbers, and modalities of nursing care should also be considered. While the WISN method is important in determining nurse workload, it must be used with other factors to ensure the standard of patient care is not compromised. This study contributes to the understanding of the practical use of the WISN method in the context of Iran's healthcare system. Abbreviations: WISN: Workload Indicators of Staffing Needs; MSA: Main healthcare services, Support, and Additional activities; ED: Emergency Department; WHO: World Health Organization; AWT: Available Working Time; CAF: Category Allowance Factor; IAF: Individual Allowance Factor; CAS: Category Allowance Standard; IAS: Individual Allowance Standard; LMICs: Low and Low Middle Income Countries. © 2023 Informa UK Limited, trading as Taylor & Francis Group.
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