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CAPC Palliative Care Discussion Forum
Staffing
FTE's per ConsultAuthor: dhilburn
Date: Apr 9, 2010 8:20 am
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Terrific question! I'm pasting below an excellent response provided by Lynn Spragens to a very similar question that was also posted on the forum:
Re:FTE's per number of consults (by lhspragens on 10/25/2007)
Cynthia, I am a consultant working with CAPC and collect a lot of info on this. There is a lot of variation in staffing and consult team model at this point. However, as a rough approximation, programs with adequate staffing are often seeing between 1 new referral per staffed bed and 2 new referrals per staffed bed per year. For example, a 200 bed hospital might have 200-400 new referrals per year.
We urge at least one dedicated fte from the beginning, and staffing as consistent with the National Consensus Project as possible. As a rough estimate, programs with 350+ new referrals have or need between 1.5 and 2 provider ftes, plus help from other team members. This includes some leadership time.
Lynn's 1-2 referrals per staffed bed ratio holds up well, I've seen lots of program's where the consult volume tracks to this raio. In deciding on the FTE required, I use an estimate of 1000 encounters (new and follow up visits) plus or minus 200 per clinical FTE. So, for every FTE of MD/APN/RN you could expect to manage 800-1200 encounters. The variation comes from the availability of other team members (social work, spiritual care, administrative support, etc.) ... so the more your clinicians are acting without support from other disciplines, the fewer clinical encounters per FTE they can manage.
I do not know of any normative or benchmarking data that addresses staffing, but I bet some will be forthcoming from the national palliaitve care registry, in time (so sign up! https://registry.capc.org/Default.aspx )
Regards, Kathleen Kerr, Senior Analyst, UCSF Pallaitive Care Leadership Center