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Large Community Hospital Reconciles Skill Mix Utilization in Orthopedic Units

success-storiesThis multi-site community teaching hospital services a multi-cultural catchment area in a urban setting. It has annual volumes of 27,855 inpatient separations, 199,115 clinic visits,
30,003 Urgent Care visits and 71,376 ER visits.

Situational Analysis

The Hospital had been using DynamineTM workload for proactive staffing and resource utilization monitoring for several years. The managers of the orthopedic units wanted to use skill mix data from the system to make improvements in care delivery. She was responsible for two orthopedic units (one of 12 beds and the other 25 beds). Historically, the larger unit had been staffed more richly with RN’s and cared for the heavier patients. The Manager wanted to admit all types of patients to both units to better utilize the bed capacity and needed to know if she needed to increase the RN resources on the smaller unit, in order to provide appropriate care to the more acute and complex patients that would now be admitted there.


The Manager contacted Emerald to request guidance in the conduct of a Skill Mix Analysis, a process that is easily carried out using the Dynamine software. Using workload / acuity data from currently existing patients, the Manager was able to create a picture of the acuity and complexity of the new unit. Dynamine then provided her with the analysis of the proportion of staff by skill level that should be assigned to the unit.


The Manager was pleasantly surprised to find that the skill mix composition on the smaller unit would be adequate to care for the higher acute, more complex patients. The RPN/LPN staff had not been working to their full scope of practice. With these results in hand, the Manager replicated the study on the larger unit. She determined that the RN complement could be reduced, still allowing staff to provide quality care to patients. Dynamine was quickly able to provide information that resulted in significant savings for the Hospital.

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