𝐀𝐝𝐣𝐮𝐬𝐭𝐞𝐝 𝐏𝐏𝐍: 𝐀 𝐒𝐦𝐚𝐫𝐭𝐞𝐫 𝐖𝐚𝐲 𝐭𝐨 𝐌𝐞𝐚𝐬𝐮𝐫𝐞 𝐍𝐮𝐫𝐬𝐞 𝐒𝐭𝐚𝐟𝐟𝐢𝐧𝐠

In healthcare, staffing decisions are often guided by metrics like 𝐇𝐏𝐏𝐃 (𝐇𝐨𝐮𝐫𝐬 𝐏𝐞𝐫 𝐏𝐚𝐭𝐢𝐞𝐧𝐭 𝐃𝐚𝐲) and the 𝐏𝐚𝐭𝐢𝐞𝐧𝐭-𝐭𝐨-𝐍𝐮𝐫𝐬𝐞 𝐑𝐚𝐭𝐢𝐨 — which we simply call 𝐏𝐏𝐍 (Patients Per Nurse).

What They Measure

• HPPD measures the total hours of nursing care provided per patient.
  It’s a retrospective tool, useful for analyzing trends and meeting regulatory requirements.
• PPN focuses on the present (and for us – the future).
  It shows how many patients are assigned to each nurse during a shift:

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The Case for Adjusted PPN

But the reality is more complex. Not all patients require the same level of care, and not all nurses have the same capacity or experience.

At In-House Health, we use 𝐀𝐝𝐣𝐮𝐬𝐭𝐞𝐝 𝐏𝐏𝐍 — an enhanced version of this metric that accounts for actual workload and nurse capability:

Workload Score (WLS)

To calculate the true workload, we factor in:

• Patient Scores
  Reflect the complexity of care needed, with scores ranging from 0.5 to 1.5 based on clinical and demographic factors.
• Usual Actions
  Includes the number of admissions and discharges, weighted to reflect their workload impact.

Adjusted Nurses

We account for roles and experience:

• Nurse managers spend more time coordinating and less on direct patient care.
• Trainee nurses take more time to complete tasks and can perform fewer actions than senior nurses.

Together, WLS and Adjusted Nurses make 𝐀𝐝𝐣𝐮𝐬𝐭𝐞𝐝 𝐏𝐏𝐍 far more representative of the actual work being done than traditional PPN.

Why does this matter?

Basic PPN can give a misleading sense of balance, while Adjusted PPN paints a more accurate picture.

It helps to:
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✔️ Distribute workloads more fairly among nurses
✔️ Avoid overstaffing or understaffing
✔️ Improve the quality of patient care