Groundwork Toolkit: Nurse staffing model for Warmbath’s Hospital

Determining staffing needs for Warmbath’s 36-bed Maternity Unit

Presenting a tool created by an MIT student team for optimizing staffing in a clinical setting

Warmbaths Hospital is a 133‐bed public district hospital in the rural Limpopo Province of South Africa. Each month, the hospital sees roughly 3000 outpatients, 1000 surgical inpatient‐days, 600 medical inpatient‐days, and 600 maternity inpatient‐days. Within the hospital, a 36‐bed Maternity Unit offers an entire range of maternity services, including antenatal, labor and delivery, neonatal, postnatal and specialty care. A dedicated team administers all patient care. The medical ward currently has one dedicated OB/GYN, one medical officer, one intern and one pediatrician who visits patients in the unit as needed. There are a total of 32 nurses staffed in the ward: 1 operational manager, 19 professional nurses, 4 staff nurses and 8 nursing assistants.

In the Fall of 2009, Warmbaths invited a team from MIT’s Global Health Delivery Lab to evaluate the staffing need of their Maternity Unit. Specifically, they requested the team build an “evidenced‐based staffing model” to determine the optimum number of nurses based on actual patient demand.

The Global Health Delivery Lab is a graduate-level class at MIT that pairs teams of graduate students with partner enterprises delivering health care in resource-limited settings in Sub-Saharan Africa and elsewhere. Part of MIT Sloan’s flagship Action Learning program, the course puts students to work on practical challenges that limit access of health care, addressing specific business and organizational needs.

Working closely with the staff, the team used observation, interviews, and time studies to piece together a patient process flow map for the Maternity Unit. They drew on their MBA education and operations management courses to calculate capacities and throughput of required resources at each step of the process and built a generalizable model that determines how many nurses are required to fulfill patient and administrative needs.


Click on the links below to download the staffing model and the accompanying how-to manual.

Nurse staffing model (xls)
How to use the model manual

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