Letters To The Editor

In response to “Front‐line ordering clinicians: Matching workforce to workload”

© 2014 Society of Hospital Medicine

We thank Dr. Louwrens for his response to our article, Front‐Line Ordering Clinicians: Matching Workforce to Workload.[1] We agree that matching workload and workforce is essential to optimizing health and financial outcomes, as well as patient and workforce satisfaction.

The articles by Elliot et al.[2] and Wachter[3] are important discussions on the relationships among workforce, efficiency, and quality outcomes. However, as Wachter notes, the same ratios are not applicable to all settings. With this in mind, our matrix tool allows individual practice settings to modify variables (such as the desired front‐line ordering clinician to workload units) based on local circumstances and validation. The tool also allows users to add variables (such as support infrastructure) that may be relevant to their setting.

We also appreciate Dr. Louwrens' comments on factors that impede the optimal matching of workload to workforce. Although barriers and resistance will always exist, we think that a data‐driven approach to measuring workload and workforce can help demonstrate need in a systematic way that can help overcome pushback. Further research correlating use of the tool to improved quality and cost outcomes will help demonstrate to institutions and payers that better matching of workforce to workload, including through flexible staffing strategies, yields higher‐value outcomes.

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