Evaluation of Electronic Health Record-Generated Work Intensity Scores and Nurse Perceptions of Workload Appropriateness

Electronic health record-generated work intensity scores represent state-of-the art functionality for dynamic nursing workload estimation in the hospital setting. In contrast to traditional stand-alone patient classification and acuity tools, electronic health record-based tools eliminate the need for dedicated data entry, and scores are automatically updated as new information is entered into patient records. This paper summarizes the method and results of evaluation of electronic health record-generated work intensity scores on six hospital patient care units in a single academic medical center. The correlation between beginning-of-shift work intensity scores and self-reported registered nurse rating of appropriateness of patient assignment was assessed using Spearman rank correlation. A weak negative correlation (-0.09 to -0.23) was observed on all study units, indicating that nurse appropriateness ratings decrease as work intensity scores increase. Electronic health record-generated work intensity scores provide useful information that can augment existing data sources used by charge nurses to create equitable nurse-patient assignments. Additional research is needed to explain observed variation in nurses' appropriateness ratings across similar work intensity point ranges.