A clockwork nursing unit. Analyzing how nurses spend their time is the first step toward improving productivity.

Until recently, productivity analysis has been a relatively underdeveloped tool in nursing. As healthcare costs continue their upward spiral, however, managers have been pressured to measure and evaluate nursing productivity. The right combination of efficiency and effectiveness is the key to optimal productivity. Nursing can be efficient but highly ineffective and thus of little value to the patient; conversely, nursing can be effective and valuable, but grossly inefficient. To determine a nursing unit's level of productivity, managers can keep a daily record of the number of nursing hours per patient day. When the record indicates too many ineffective or inefficient days, an analysis of how nurses use their time can help solve the problem. The first step is such an analysis is to have management engineering or the nursing staff itself collect data on time spent per task. Once these data are collected, they can be analyzed by shift (for the entire hospital), by individual unit, by task category, etc. With this information in view, managers can ask key questions to help pinpoint areas where efficiency might be improved.