Authors: Ahmed Zaki Mustafa , Shiv Bhagwan Dhayal , Kanchana Ramachandran , Dania Amer Alhijjawi

Abstract

Background: Optimal nurse staffing is essential for delivering high-quality, patient-centered care. Traditional staffing approaches often fail to reflect real-time patient acuity, potentially leading to suboptimal outcomes and increased operational costs. Evidence-based strategies are therefore needed to align staffing with patient needs and ensure efficiency.
Objectives: To optimize nurse staffing using an evidence-based acuity platform, with the aim of improving patient outcomes and reducing staffing-related costs.
Methods: This quality improvement study was conducted at Care Medical Al-Rawabi, Saudi Arabia, from January to June 2024. A Lean Six Sigma framework guided the intervention across five phases: Define: Inefficiencies in existing staffing practices were identified. Measure: Data on patient acuity, staffing levels, and overtime hours were collected. Analyze: Pareto charts were used to determine root causes of staffing inefficiencies. Improve: A standardized acuity-based tool was introduced to match staffing with patient complexity. Control: Ongoing monitoring ensured sustained performance and process refinement.
Results: Following the implementation of the evidence-based staffing platform, the hospital achieved a zero peripheral IV site infiltration rate for five consecutive quarters. The incidence of patient falls and hospital-acquired infections declined to levels below international benchmarks, indicating enhanced patient safety. Additionally, there was a significant reduction in overtime costs, resulting in savings of 1,211,755 Saudi Riyals. The platform also contributed to improved patient assignment scores and increased registered nurse (RN) job satisfaction. Notably, the proportion of nursing care hours delivered by RNs reached 98.97%, exceeding the international benchmark of 74.81%.
Conclusion: The evidence-based staffing platform led to measurable improvements in patient safety, nurse workforce utilization, and cost efficiency. Its implementation supports the strategic alignment of staffing practices with patient needs in high-acuity healthcare settings.

Keywords: Evidence-based staffing platform, nurse staffing, patient care, in Saudi Arabia.