An experience with the use of WISN tool to calculate staffing in a palliative care hospital in Brazil

Abstract Background The article describes a healthcare staffing exercise that took place in a Cancer Hospital IV, Brazil’s first public palliative care unit. There are numerous gaps in the literature on specialized cancer staffing. Palliative care is a therapy modality that should begin with the dia...

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Main Authors: Alessandra Pereira da Silva, Mario Roberto Dal Poz
Format: Article
Language:English
Published: BMC 2022-01-01
Series:Human Resources for Health
Subjects:
Online Access:https://doi.org/10.1186/s12960-021-00680-2
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author Alessandra Pereira da Silva
Mario Roberto Dal Poz
author_facet Alessandra Pereira da Silva
Mario Roberto Dal Poz
author_sort Alessandra Pereira da Silva
collection DOAJ
description Abstract Background The article describes a healthcare staffing exercise that took place in a Cancer Hospital IV, Brazil’s first public palliative care unit. There are numerous gaps in the literature on specialized cancer staffing. Palliative care is a therapy modality that should begin with the diagnosis of a chronic disease, at which point the personnel must be technically and numerically adequate, as well as well-distributed, to provide coverage of the population that requires this type of care. Methods The WISN tool was chosen after a systematic review of the use of workload studies in palliative care, because it fulfills this objective. The WISN method is based on a health worker's workload, was developed in the late 1990s in the health sector and has been field-tested and implemented in several countries. Direct observation was used as the fieldwork approach, which was carried out by 18 research assistants with the assistance of two supervisors. They monitored 60 professionals in seven categories for 2 weeks on weekdays in the morning and afternoon periods: nursing, pharmacy, physical therapy, medical, nutrition, psychology, and social services. Results Except for the medical staff, which at the time included additional physicians on loan from a partner institution to address a shortage in this professional group, all categories exhibited overload with WISN ratios ranging from 0.53 to 0.97. The analysis of time spent on individual activities indicated flaws with the services' informal organizations. The authors also noticed a strong emphasis on support activities and a lack of a clear schedule for training and research. The study's findings included a definition of standard activities for each professional group, an analysis and comparison of activities by categories, departments, and work shifts, a standard workload for training and research, and recommendations to include human resources planning as a fundamental part of a national policy for palliative care. Conclusions The WISN tool can be used to plan human resources in cancer centers that provide palliative care, and it provides for a variety of analyses that can be combined with other approaches in the literature.
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spelling doaj.art-46047063b263469c808bdce211b77d572022-12-21T17:48:22ZengBMCHuman Resources for Health1478-44912022-01-0119S11910.1186/s12960-021-00680-2An experience with the use of WISN tool to calculate staffing in a palliative care hospital in BrazilAlessandra Pereira da Silva0Mario Roberto Dal Poz1National Institute of Cancer José Alencar Gomes da SilvaSocial Medicine Institute, University of State of Rio de Janeiro (IMS/UERJAbstract Background The article describes a healthcare staffing exercise that took place in a Cancer Hospital IV, Brazil’s first public palliative care unit. There are numerous gaps in the literature on specialized cancer staffing. Palliative care is a therapy modality that should begin with the diagnosis of a chronic disease, at which point the personnel must be technically and numerically adequate, as well as well-distributed, to provide coverage of the population that requires this type of care. Methods The WISN tool was chosen after a systematic review of the use of workload studies in palliative care, because it fulfills this objective. The WISN method is based on a health worker's workload, was developed in the late 1990s in the health sector and has been field-tested and implemented in several countries. Direct observation was used as the fieldwork approach, which was carried out by 18 research assistants with the assistance of two supervisors. They monitored 60 professionals in seven categories for 2 weeks on weekdays in the morning and afternoon periods: nursing, pharmacy, physical therapy, medical, nutrition, psychology, and social services. Results Except for the medical staff, which at the time included additional physicians on loan from a partner institution to address a shortage in this professional group, all categories exhibited overload with WISN ratios ranging from 0.53 to 0.97. The analysis of time spent on individual activities indicated flaws with the services' informal organizations. The authors also noticed a strong emphasis on support activities and a lack of a clear schedule for training and research. The study's findings included a definition of standard activities for each professional group, an analysis and comparison of activities by categories, departments, and work shifts, a standard workload for training and research, and recommendations to include human resources planning as a fundamental part of a national policy for palliative care. Conclusions The WISN tool can be used to plan human resources in cancer centers that provide palliative care, and it provides for a variety of analyses that can be combined with other approaches in the literature.https://doi.org/10.1186/s12960-021-00680-2PlanningManagementStaffingPalliative careWISN
spellingShingle Alessandra Pereira da Silva
Mario Roberto Dal Poz
An experience with the use of WISN tool to calculate staffing in a palliative care hospital in Brazil
Human Resources for Health
Planning
Management
Staffing
Palliative care
WISN
title An experience with the use of WISN tool to calculate staffing in a palliative care hospital in Brazil
title_full An experience with the use of WISN tool to calculate staffing in a palliative care hospital in Brazil
title_fullStr An experience with the use of WISN tool to calculate staffing in a palliative care hospital in Brazil
title_full_unstemmed An experience with the use of WISN tool to calculate staffing in a palliative care hospital in Brazil
title_short An experience with the use of WISN tool to calculate staffing in a palliative care hospital in Brazil
title_sort experience with the use of wisn tool to calculate staffing in a palliative care hospital in brazil
topic Planning
Management
Staffing
Palliative care
WISN
url https://doi.org/10.1186/s12960-021-00680-2
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