Tuesday, 9 May 2017

Balancing Quality, Cost and the Nursing Workforce

Balancing Quality, Cost and the Nursing Workforce

Claire Su-Yeon Park, MSN, RN
CEO, Center for Econometric Optimization in the Nursing Workforce, Seoul


How can we achieve value-based nursing care resulting from improved quality yet reduced cost? We long for the best point of leverage balancing quality and cost; however, most studies seem to still present fragmented “snap shots” of the phenomenon of interest. We should be mindful of this because an unclear picture may lead to muddled policy-making. In this regard, I proposed a theory entitled “Park’s Optimized Nurse Staffing (Sweet Spot) Estimation Theory” which explains “the inter-relationship in the continuum of changes between quality of care and cost, in particular, as they relate to nurse staffing.” The study “Optimizing staffing, quality and cost in home healthcare nursing: Theory synthesis” (Park 2017) is published in JAN.

I took note of inconsistent and non-conclusive evidence on both quality and cost in home healthcare, gaining insight into the limited theoretical basis on the dynamics between quality and cost that such evidence must be built upon.

To address this discrepancy, we created “Park’s Optimized Nurse Staffing (Sweet Spot) Estimation Theory” through the theory synthesis process, which helps determine a practical and applicable optimum level of nursing staffing where nurses, patients and healthcare organizations (or stakeholders) can all be satisfied. The specific approach pinpoints “the theory-driven Optimum Nurse Staffing Zone as well as the Optimized Nurse Staffing (Sweet Spot), which can be navigated by Mathematical Programming (Optimization) based on the Duality Theorem in Mathematical Economics (Diewert 1982, p. 556)” (Park 2017). The “Optimized Nurse Staffing (Sweet Spot)” signifies a single best point of leverage “to achieve the maximum quality of care for patients while simultaneously delivering nurse staffing in the most cost-effective way” (Park 2017).

Non-linear optimization illustration produced by MATLAB

My theory could significantly impact nursing workforce policy-making to ensure optimal patient care relative to cost. “Not only does it address a timely issue – i.e., the balance between quality and cost – in the healthcare delivery system, but it is also applicable, durable and valuable due to the fact that Park’s Optimized Nurse Staffing (Sweet Spot) Estimation Theory can be used to determine the sweet spot among quality, nurse staffing and cost in any healthcare/research setting” (Park 2017). Innovation in the healthcare delivery system as well as advancing nursing practice in real-world situations would be ultimately achievable.


Claire Su-Yeon Park, MSN, RN
CEO, Center for Econometric Optimization in the Nursing Workforce
Seoul, Republic of Korea
clairesuyeonpark@gmail.com

References

DIEWERT W.E. (1982) Duality approaches to microeconomic theory. In Handbook of Mathematical Economics: Volume II (Arrow K.J. & Intiriligator M.D., eds.), North-Holland Publishing Company, Amsterdam, Netherlands, pp. 535-599.

PARK C.S. (2017) Optimizing staffing, quality and cost in home healthcare nursing: Theory synthesis. Journal of Advanced Nursing. doi: 10.1111/jan.13284.



Note: This article is published under an exclusive license agreement with John Wiley & Sons, Limited; Park’s Optimized Nurse Staffing (Sweet Spot) Estimation Theory: Copyright ⓒ 2016 Park, Claire Su-Yeon. All Rights Reserved. The copyright has been registered in Korea [C-2016-031091] and is pending in the U.S.A. [1-4218094011] with an effective copyright date of 02 Dec 2016; patent-pending in Korea (Park’s User-friendly Cloud-based Intersectional Optimized Nurse Staffing (Sweet Spot) Decision-making Support System [10-2017-0052130] with an effective patent-pending date of 24 Apr 2017); the Patent Cooperation Treaty (PCT) patent claiming priority of the Korean patent application pending [in progress]. Use of the contents, illustrations, and even ideas in Park’s Optimized Nurse Staffing (Sweet Spot) Estimation Theory, even in part, requires written permission from the copyright/patent holder.



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