Optimizing nurse staffing through predictive centralized tools

Staffing shortages aren't just numbers — they impact patient care, nurse well-being, and hospital finances. What if nurse leaders could see staffing days (and even weeks) ahead and take proactive action, instead of reacting to crises as they arise?

Persistent workforce shortages, severe fractures in the supply chain for drugs and supplies, and high levels of inflation have collectively fueled hospitals’ costs as they care for patients 24/7.

Hospitals’ labor costs increased by more than $42.5 billion between 2021 and 2023 to a total of $839 billion, increasing as a % of total budget and now accounting for nearly 60% of the average hospital’s expenses. Hospitals continue to turn to expensive contract labor to fill gaps and maintain access to care, spending approximately $51.1 billion on contracted staff in 2023.

In general, there is a growing demand for care. Many healthcare systems are struggling to keep up with an aging population's increasingly complex healthcare needs. Health systems are revamping patient admission and discharge processes, as well as introducing new virtual, urgent, and home care offerings. But still, many providers are concerned they won’t be able to act quickly enough to meet the growing demand. Some even call it a “tsunami of patients”.

Given all the above, being a Chief Nursing Officer (CNO) today is more demanding than ever. Every nurse shift is critical, which means that precision staffing is critical - which demands new tools.

Retrospective/real-time is powerful, but…

Tools used for staffing decisions often tend to be (a) more financial in nature, without sufficient clinical context (e.g., acuity) and (b) real-time at best, and often only retrospective. When nursing leaders like DoNs or Float Pool Directors are managing off of last month’s productivity data, or scanning the EMR unit-by-unit to gauge census, it is hard to make informed decisions- especially ones that anticipate trends into the future.

At In-House, we augment these systems with a predictive, forward-looking platform that integrates financial/clinical information for nurse leaders to make informed staffing decisions, to take existing operational visibility to the next level. DoNs and Float Pool Directors, use the In-House platform to evaluate comprehensive census trends and staffing forecasts, enabling decisions informed by predictive hospital diversions, ER Boarding, and OR schedule changes. 

Imagine this: It's Monday morning, and relevant people (and those can vary, depending on the flow, size, and accepted routine of the organization) deal with staffing issues. Instead of scrambling for last-minute staffing solutions, they confidently review a clear, real-time visualization of staffing across the entire hospital. This dashboard doesn't just show today — it predicts staffing (and other potential metrics) for the next two weeks.
At Assuta Medical Center, the CNO uses this exact capability to prepare for weekends — a non-operational period when admissions stop and some units temporarily close. With a hospital-wide view of patient loads and nurse availability, he quickly identifies which departments will face pressure and which will have capacity. He then speaks directly with department heads to plan ahead: deciding which units to close and where to transfer patients in order to balance the load without compromising care.
Another example would be identifying delays in discharges. Hospital-level management can investigate the cause in real time and promote the discharge of patients who should no longer be in the unit. During leadership meetings, the Command Center empowers nursing leadership to present clear, data-driven insights about staffing needs and resource allocation, elevating their strategic role and fostering informed decision-making across hospital leadership.

The “Nursing Command Center” can offer exactly this level of operational insight and predictive capabilities weeks in advance, bridging the gap between what other tools can already show today and the strategic foresight that leaders increasingly need. It doesn't replace existing data systems — it enhances them by extending visibility into the near future, giving administrators a crucial head start in a constantly shifting environment, empowering senior administrators to make strategic, data-driven staffing decisions.

For a deeper understanding of how our predictive analytics work, [read more here].

Key Nursing Command Center Metrics:

• Census: Real-time and predictive patient counts and bed occupancy percentages.
• Patients Per Nurse (PPN): Clear visual indicators (speedometers) showing optimal, high, or low ratios, adjusted both for patient workload and for nurse tenure & training.  Learn more about In-House’s adjusted PPN metric [here].
• Hourly Occupancy Analytics: Detailed hourly workload data and predictive staffing insights for the upcoming two weeks.
• Patient Admissions/Discharges: Essential metrics impacting dynamic staffing decisions and resource allocation.
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Conclusion:

In a healthcare environment that often feels like a battlefield, acting in the moment is no longer enough when patient volumes shift by the hour and staffing decisions carry weight across departments.

The ability to anticipate what's coming — to plan ahead based on reliable prediction, not just current load — transforms leadership from reactive control to strategic readiness.

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