Cloud health Solution

- changing healthcare dynamics


Software: Nurse Optima

As the industry forays into a new era of tech-powered healthcare, definitive solutions are required to focus at specific areas within the heath value chain.

Hospitals traditionally assigned Nurse staffing and Nursing assignment tool based on patient needs, with the charge nurse on each shift determining how many patients each nurse will care for and where unlicensed and assistive personnel will be deployed.

Nurse Optima, a decision support system for Nurse staffing and Nursing assignment tool (DSS-NS) powered by Cloud Health Solution is a Healthcare analytics solution designed to provide Business Intelligence for acuity based Nurse staffing and Nursing assignment tool in Hospitals.

With Nurse Optima we at Cloud health solution look at new ways to implement business-driven technology solutions that integrate business processes, increase worker productivity, improve patient outcome and create a more agile enterprise to respond better to new business opportunities.

Benefits of Nurse Optima

  • Helps in making informed decisions
  • Analyze trends and performance
  • Track your business goals
  • Predictive modeling (Data Mining - budgeting, training module etc.)
  • Performance management
  • Dashboards
  • Data Mining (Forecasting patient mix, staff planning etc.)
  • Operates seamlessly-Integrates easily with existing Systems

Nurse Optima helps us to look forward to a future where nurses and the entire health care team embed evidence and not opinion into staffing.

Joint Commission International (JCI)


Standard COP.1 c: Acuity of the patient’s condition determines the resources allocated to meet the patient’s needs.

CHAPTER 13 - Staff Qualifications and Education (SQE)

Standard SQE.6.1: The staffing strategy is reviewed on an ongoing basis and updated as necessary.

Intent of SQE.6 and SQE.6.1
Appropriate and adequate staffing is critical to patient care as well as to all teaching and research activities in which the hospital may be engaged.
Staff planning is carried out by department/service leaders. The planning process uses recognized methods for determining levels of staffing.
For example, a patient acuity system is used.

Standard SQE.14.1

The hospital has a standardized process for nursing staff participation in the hospital’s quality improvement activities, including evaluating individual performance when indicated.

Measurable Elements of SQE.14

  • Licensure, education/training, and experience of a nursing staff member are used to make clinical work assignments.
  • The process takes into account relevant laws and regulations.
  • The process supports Nurse staffing and Nursing assignment tool plans.

Nurse Optima (a patient acuity tool) helps fulfill these Measurable / Objective Elements in an efficient and cost effective manner.

National Accreditation Board for Hospitals and Healthcare Providers (NABH)


Standard COP 6: Documented policies and procedures guide nursing care.

Objective Elements

  • COP 6 c. Assignment of patient care shall be based on the patient‘s clinical requirements and shall incorporate the guidelines laid down by regulatory and professional bodies.
  • COP 6 d. Nursing care is aligned and integrated with overall patient care. The nursing Care plan shall be aligned with the Care plan of the patient. Uniformity and continuity of care should be practiced.
  • COP 6 g. Nurses are empowered to take nursing-related decisions to ensure the timely care of patients.

Standard COP.9: Documented policies and procedures guide the care of patients in the intensive care and high dependency units.

Objective Elements

  • COP 9 a. Documented policies and procedures are used to guide the care of patients in the intensive care and high dependency units. * Interpretation: At a minimum this should include as to how care is organized, how patients are monitored and the nurse-patient ratio.

CHAPTER 6- Continuous Quality Improvement (CQI)

Standard CQI.4: The organization identifies key indicators to monitor the managerial structures, processes and outcomes, which are used as tools for continual improvement.

Objective Elements

  • HRM 1 a. Human resource planning supports the organization’s current and future ability to meet the care, treatment and service needs of the patient.
    *Interpretation: This shall be done in a structured manner keeping in mind the hospital’s mission, volume and mix of patients, services, and medical technology.
    This is done with involvement of various stake holders. It shall use recognized methods for determining levels of staffing.
    Nurse Optima It shall match the strategic and operational plan of the organization.

Nurse Optima (a patient acuity tool) helps fulfill these Measurable / Objective Elements in an efficient and cost effective manner.

Why maintaining appropriate Nurse Patient ratio is important?

When nurses were asked to report their perceptions of the staffing levels in their hospitals, only 34 percent said they had enough R.N.s to provide quality care; and still fewer, 33 percent, had enough staff to get their work done. Of these nurses, 83 percent had experienced an increase in the number of patients assigned to them.

Not surprisingly, nurses have also reported dissatisfaction with the outcomes of their work and have real concerns about the risks to patients: only 36 percent describe the quality of care in their hospital as excellent; while 45 percent report that the quality of care has deteriorated in the last year; and 49 percent report receiving frequent complaints from patients and families.

Insufficient staffing not only adversely impacts health care quality and patient safety; it also compromises the safety of nurses themselves. The risk of having a needle stick injury is two-to-three times higher for nurses in hospitals with low staffing levels and/or poor working climates.

The Nurse Optima allows an administrator to determine the staffing levels, based on the Acuity Grading Tool scoring, with the click of a mouse, as well as, perform budgetary estimations via Nurse Optima acuity-based staffing projections.

This module is a predictor of staffing needs. When used properly, a manager can see when the number of clients or health risk levels have risen or fallen, and can accurately determine the staffing levels needed at that precise moment in time. This is not only a great time and money saver, but it also allows for the best possible care to be provided, by the most appropriate staff.

With Nurse Optima managers can more evenly distribute complex admitted cases among nurses and promote consistent assignments, thereby promoting fairness, avoiding understaffing and improving workforce satisfaction and quality of care

Features of Nurse Optima

    The Nurse Optima is a powerful and easy to use package of nursing tools that:
  • grades Patient Acuity,
  • calculates Staffing requirements based on census and acuity
  • provides Inter-shift Communication Masters for Charge Nurses
  • generates Staff Shift Assignments,
  • stores patient care-specific data

Nurse Optima helps us to look forward to a future where nurses and the entire health care team embed evidence and not opinion into staffing.

What is Acuity based staffing?

Acuity is the individual patient’s need for care.

Patient acuity systems give hospitals flexibility to maximize staffing effectiveness. The systems demonstrate how hospitals can provide adequate staffing based on actual patient needs, rather than restrictive ratios.

Why is Acuity based staffing needed?

According to Joint Commission data as of March 2002, staffing levels have been a factor in 24 percent of the 1609 sentinel events (unanticipated events that result in death, injury or permanent loss of function) that have been reported.

Several studies have shown the positive impact on quality, costs and health outcomes when Nurse staffing and Nursing assignment tool levels are optimized – fewer complications, fewer adverse events, shorter lengths of stay, lower mortality.

The rates for all four nurse-sensitive indicators decreased (falls incidence, catheter associated urinary tract infections, central line–associated bloodstream infections, and pressure-ulcer prevalence) after staffing was adjusted to account for higher-acuity patients.

A lower number of deaths were associated with a nurse ratio of one R.N. to six patients versus a ratio of one R.N. to ten patients.

Why should we examine the benefits of acuity-based staffing?

Currently, many countries have legislations regarding Nurse staffing and Nursing assignment tool in hospitals; some address nurse-patient ratios, while others require various levels of reporting and accountability. This legislative momentum will likely continue, creating a legal impetus for healthcare organizations around the country to begin implementing more comprehensive staffing systems based on acuity. Acuity-based staffing is linked to a host of benefits, making adoption of data-driven acuity systems all the more compelling.

Positive clinical and operational outcomes linked to acuity based staffing include decreases in mortality, adverse outcomes, and lengths of stay.

Why should hospital consider Acuity based staffing?

Inefficient processes to handle fluctuating staffing needs can impact labor costs, take valuable time away from patient care priorities, and frustrate nurses. Acuity software like Nurse Optima lets you immediately notify nurses about open shifts based on nurse-indicated availability and who else is scheduled to work that shift.

By examining detailed patterns and levels of staffing, based on workload as opposed to number of patients, nurse leaders can staff units at levels that enhance the ability to provide optimal clinical care and affect outcomes positively.

If evidence-based staffing was the prevailing staffing approach, there would be a very different picture of patient outcomes, financial performance, operational efficiency, workforce stability, and engagement. All of this puts evidence-based staff i n g at the top of the list.

While change is never easy, it is feasible that letting go of the gross inefficiencies, habits, traditions, policies, and practices that will be replaced by evidence based staffing will ultimately not be so hard.

Key Benefits of Acuity-Based Nurse staffing and Nursing assignment tool

  • Nurse satisfaction and retention

    Acuity-based assignment methods are beneficial for maintaining high employee satisfaction. Just as each patient is different, each nurse brings different experiences and strengths to the job. Matching nurses with patients that complement their skills and preferences can help improve nurse retention by avoiding the situations that increase unwanted employee turnover, due to burnout, fatigue or general dissatisfaction. Conscientious employers recognize continuous recognition and utilization of individual nurse qualities increases productivity and keeps nurses satisfied with their role on a daily basis.

  • Reduced costs

    Nurse burnout, retention, and satisfaction also have a direct impact on a hospital's bottom line. Nurses want to treat all of their patients safely, effectively, and compassionately. However, when their workload is not balanced and nurse assignments prohibit them from providing adequate care, dissatisfaction begins to take over and turnover rates increase. Replacing a healthcare employee can cost as much as 250% of their salary.

  • Improved patient outcomes

    In a value-based market, where outcome metrics are tied to financial performance of the organization, acuity-based staffing can help achieve a higher likelihood for positive outcomes. Accurately balancing patient care needs with nurse workload and skill mix can help maximize potential revenue and minimize harm. Having nurses with the right skill sets and the necessary competencies readily available to take care of the right patient at the right time is essential to achieving quality of care, patient safety, and financial health goals in this new era of value-based purchasing.

  • With the advent of various National and International accreditation bodies like Joint Commission International (JCI), National Accreditation Board for Hospitals & Healthcare Providers (NABH),Accreditation Canada International (ACI),Quality Health New Zealand (QHNZ), Saudi Central Board for Accreditation of Healthcare Institutions (CBAHI), QHA Trent Accreditation etc the Healthcare organizations are looking through the lens of state legislation focused on safe nurse-patient ratios.

  • Using Nurse Optima can be a marketing tool for the hospital as it focuses on the adequate care per patient.

In Nutshell

The Nurse Optima is designed to help nurses receive safe, fair and balanced patient assignments and encourage efficient and timely shift reports. The Acuity Grading Tool helps Charge Nurses to quickly generate patient care assignments that are based on the census, the care level of patients and the facility's staffing policies. The Staffing Mix Calculator and the Staff Assignment Tool then print out all the patient care data for each nurse and aide, ensuring accurate and legible patient care worksheets at the beginning of each shift. The goal of this software is to help the nursing staff to perform their duties more efficiently and effectively...working smarter, not harder. With the movement grounded in science and guided by experience and wisdom, it seems safe to assume that we can get there quickly


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