Modelling midwifery care demand and supply – analysis of longitudinal routine hospital data
Notice bibliographique
Résumé
Introduction A staffing shortage of registered nurses and midwives was identified in Switzerland. There is no recommendation on midwifery staffing and current staffing levels in Swiss maternity wards are unknown. The aim of this study was to model current care demand and care supply by midwives in a maternity department of a Swiss university hospital. Methods Single-centre retrospective observational longitudinal study investigated a time frame of four years (2019-2022). The main setting of interest was the labour ward with 2,500 births annually. Working with routine hospital data, we included all maternal and neonatal patients who were admitted as inpatients to the study setting. Registered midwives from the labour ward, who are scheduled in a three-shift pattern (day, late, and night shift) were also included. To model the care demand side, we worked with the number of birthing parents and newborns. Based on the goal to provide 1-to-1 care we counted the number of midwifery working hours as care supply and the number of hours patients were present as care demand for each shift. Care demand hours were subtracted from care supply hours for each shift to calculate the supply-demand-match. Results In total 10,458 births occurred during 4,383 shifts. Preliminary results show high variation in the number of births daily with a range from zero up to 17 births during one day and a yearly average of seven births per day ([ Fig. 1 ]). Abb. 1 The average number of care supply was 44.1 hours per shift (SD+/- 6.6 hours), and 48.4 hours for care demand (SD+/- 17.1 hours). Regarding the mismatch between care supply and care demand, this resulted in -4.3 hours per shift (SD+/- 15.4 hours) or -0.5 midwives per shift ([ Fig. 2 ], only the year 2022 is shown representatively for the complete time frame). On average one midwife was missing during day shifts (mean=-8.0 hours, SD+/-15.9 hours), a good match was apparent for late shifts (mean=-0.4 hours, SD+/- 14.5 hours), and half a midwife was missing during night shifts (mean=-4.5 hours, SD+/- 14.8 hours). Abb. 2 Discussion Showing this match between care demand and care supply increases the understanding of the current staffing schedule in one Swiss university hospital. Given that we will face continued staffing shortages in the near future, it is critical to search for solutions to improve the match between demand and supply. Without any additional midwifery staff there is potential through improved alignment between care demand and care supply. Adapting staff scheduling based on the number of pregnant parents registered for birth in the hospital per month might offer this possibility. In this representation of care demand we didn"t include the complexity of patients, which will be done in a next step to improve the understanding of care demand variation in Swiss labour wards and its effect on the supply-demand-match. Publication History Article published online: 15 November 2023 © 2023. Thieme. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany
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Prédiction machine sur la base complète
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Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,004 | 0,013 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,002 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,002 | 0,001 |
| Intégrité de la recherche | 0,002 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».