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Substantial differences in efficient management and use of nursing resources by health authorities

​There are major differences in how efficiently the health authorities use nursing staff. The Office of the Auditor General's investigation shows that there is wide variation among similar wards. “More efficient use can free up resources to treat more patients,” says Auditor General Per-Kristian Foss.

Published 9/29/2015 11:00 AM

Document 3:12 (2014–2015) The Office of the Auditor General's investigation of management of nursing resources in the health trusts was submitted to the Storting on 29 September.

The audit shows that management information does not provide a sufficient basis to ensure efficient use of nursing staff, that staffing in many cases is not adapted to varying patient occupancy, and that collaboration and exchange of experiences can increase efficiency. The OAG examined 77 wards spread across six disciplines from January 2013 to January 2015. There are major differences between comparable wards, and most could be more efficient. "In 2013, an increase to a separately stipulated average productivity level in the months they were below this level would have freed up 5 per cent of duty hours," says Foss.

Less than half of middle managers of wards in the audit believe that they have enough information to assess whether staff are used efficiently. Financial limits are largely determined on the basis of the previous year's budget, results and patient occupancy. Information about the relationship between staffing and patient occupancy, and information about hospital stays and care needs are hardly utilised. "We recommend using management indicators that can show whether care resources are used efficiently by the wards," says Foss.

Half of the wards have similar staffing even when there are predictable variations in patient occupancy on weekdays. The OAG recommends continued efforts to ensure that managers have the necessary skills, tools and information to achieve efficient use of nursing staff.

Eight out of ten wards with high productivity collaborate with other units to deal with absenteeism due to illness and unexpected variations in patient occupancy. Only half as many with low productivity do the same. "We recommend more collaboration to achieve more efficient use overall," says Auditor General Foss.

The Minister of Health and Care services believes that the OAG's investigation and recommendations are a good contribution to future management and will provide the trusts with useful knowledge. The minister will follow up the audit in the management dialogue.

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