Fractions of Effort

Proposal analyses might indicate that the new IT initiative will save fractions of staff time, for example, that each nurse will spend fifteen minutes less per shift on clerical tasks. To suggest a total value, the proposal might multiply as follows (this example is highly simplified): 200 nurses × 15 minutes saved per 8-hour shift × 250 shifts worked per year = 12,500 hours saved. The math might be correct, and the conclusion that 12,500 hours will become available for doing other work such as direct patient care might also be correct. But the analysis will be incorrect if it then concludes that the organization would thus “save” the salary dollars of six nurses (assuming 2,000 hours worked per year per nurse).

Saving fractions of staff effort does not always lead to salary savings, even when there are large numbers of staff members, because there may be no practical way to realize the savings—to, for example, lay off six nurses. If, for example, there are six nurses working each eight-hour shift in a par­ticular nursing unit, the fifteen minutes saved per nurse would lead to a total savings of 1.5 hours per shift. But if one were then to lay off one nurse on a shift, it would reduce the nursing capacity on that shift by eight hours, damaging the unit’s ability to deliver care. Saving fractions of staff member effort does not lead to salary savings when staff members are geographically highly fragmented or when they work in small units or teams. It leads to possible salary savings only when staff members work in very large groups and some work of the reduced staff members can be redistributed to others.

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