Assessing health workers need in healthcare facilities (HF) through Evidence-Based Management, Puerto Rico, 2013

Issue: Adequate staffing of healthcare facilities (HF) yield better patient care outcomes. However, determining staffing needs in HF is challenging. Access to evidence-based tools for staffing needs can assist health managers in these decisions.  

 Description of the project: The Workload Indicators of Staffing Needs (WISN), developed by WHO, is an evidence-based management tool that helps determine needs and appropriate distribution of health workers in HF. The WISN tool was used to assess services and quality in Puerto Rico Department of Health (PRDOH) STD/HIV clinics (N=10). Supervisor and staff interviews, official reports and databases were used to determine essential work-activities/task and timeframes. Analyses were performed for all clinics using WISN tools and software.

 Lessons learned: WISN analyses demonstrated 90% of clinics were short-staffed with high workload pressure. WISN allowed stakeholders at PRDOH to prioritize staffing needs for its STD/HIV clinics; 11 out of 18 new positions were prioritized for immediate recruitment. After the fulfillment of 11 of 18 new positions, 70% of clinics will continue to see staff shortages and high workload pressure. To date 8 out of the 11 key new positions have been filled and already improvements in workload pressure have been observed. Successful tool implementation is labor intensify and requires engaged stakeholders; nonetheless, the activity proved to be useful in effectively reducing workload pressure.

 Recommendations: The WISN tool can assist Public Health Departments, particularly decentralized, primary health care facilities in efficiently addressing staffing needs while striving for improvements in patient care outcomes.