NHS managers’ use of nursing workforce planning and deployment technologies: a realist synthesis

Background:
Policy and reviews of health-care safety and quality emphasise the role of NHS managers in ensuring safe, good-quality patient care through effective staffing. Guidance requires that NHS managers combine professional judgement with evidence-based workforce planning and deployment tools and technologies (WPTs). Evidence has focused on the effectiveness of WPTs, but little is known about supporting their implementation, or the impact of using WPTs across settings.

Objectives:
The review answered the following question: ‘NHS managers’ use of workforce planning and deployment technologies and their impacts on nursing staffing and patient care: what works, for whom, how and in what circumstances?’.

Design:
A realist synthesis was conducted. A programme theory was formulated and expressed as hypotheses in the form of context, mechanisms and outcomes; this considered how, through using WPTs, particular conditions produced responses to generate outcomes. There were four phases: (1) development of a theoretical territory to understand nurse workforce planning and deployment complexity, resulting in an initial programme theory; (2) retrieval, review and synthesis of evidence, guided by the programme theory; (3) testing and refinement of the programme theory for practical application; and (4) actionable recommendations to support NHS managers in the implementation of WPTs for safe staffing.

Participants:
NHS managers, patient and public representatives and policy experts informed the programme theory in phase 1, which was validated in interviews with 10 NHS managers. In phase 3, 11 NHS managers were interviewed to refine the programme theory.

Results:
Workforce planning and deployment tools and technologies can be characterised functionally by their ability to summarise and aggregate staffing information, communicate about staffing, allocate staff and facilitate compliance with standards and quality assurance. NHS managers need to combine local knowledge and professional judgement with data from WPTs for effective staffing decisions. WPTs are used in a complex workforce system in which proximal factors (e.g. the workforce satisfaction with staffing) can influence distal factors (e.g. organisational reputation and potential staff recruitment). The system comprises multiple organisational strategies (e.g. professional and financial), which may (or may not) align around effective staffing. The positive impact of WPTs can include ensuring that staff are allocated effectively, promoting the patient safety agenda within an organisation, learning through comparison about ‘what works’ in effective staffing and having greater influence in staffing work. WPTs appear to have a positive impact when they visibly integrate data on needs and resources and when there is technical and leadership support. A collaborative process appears to be best for developing and implementing WPTs, so that they are fit for purpose.

Limitations:
The evidence, predominantly from acute care, often lacked detail on how managers applied professional judgement to WPTs for staffing decisions. The evidence lacked specificity about how managers develop skills on communicating staffing decisions to patients and the public.

Conclusions and recommendations:
The synthesis produced initial explanations of the use and impact of WPTs for decision-making and what works to support NHS managers to use these effectively. It is suggested that future research should further evaluate the programme theory.

1.
Griffiths P, Ball J, Drennan J, Dall’Ora C, Jones J, Maruotti A, et al. Nurse staffing and patient outcomes: strengths and limitations of the evidence to inform policy and practice. A review and discussion paper based on evidence reviewed for the National Institute for Health and Care Excellence Safe Staffing guideline development. Int J Nurs Stud 2016;63:213–25. 10.1016/j.ijnurstu.2016.03.012 [PubMed] [CrossRef]
2.
Francis R. Report of Mid Staffordshire NHS Foundation Trust Public Inquiry: Executive Summary. HC 947. London: The Stationery Office; 2013.
3.
Keogh B. Review into the Quality and Care and Treatment Provided by 14 Hospital Trusts in England: Overview Report. London: NHS England; 2013.
4.
Berwick D on behalf of the National Advisory Group on the Safety of Patients in England. A Promise to Learn – A Commitment to Act: Improving the Safety of Patients in England. London: Department of Health and Social Care; 2013.
5.
Commissioning Board Chief Nursing Officer and Department of Health and Social Care Chief Nursing Adviser. Compassion in Practice. Nursing, Midwifery and Care Staff: Our Vision and Strategy. 2012. URL: www​.england.nhs.uk/wp-content​/uploads/2012​/12/compassion-in-practice.pdf (accessed September 2017).
6.
National Quality Board (NQB). How to Ensure the Right People, with the Right Skills, Are in the Right Place at the Right Time a Guide to Nursing, Midwifery and Care Staffing Capacity and Capability. London: NQB; 2013. URL: www​.england.nhs.uk/wp-content​/uploads/2013​/11/nqb-how-to-guid.pdf (accessed September 2017).
7.
National Quality Board (NQB). Supporting NHS Providers to Deliver the Right Staff, with the Right Skills, in the Right Place at the Right Time. Safe Sustainable and Productive Staffing. London: NQB; 2016. URL: www​.england.nhs.uk/wp-content​/uploads/2013/04/nqb-guidance​.pdf (accessed September 2017).
8.
National Institute for Health and Care Excellence (NICE). Safe Staffing for Nursing in Adult Inpatient Wards in Acute Hospitals. Safe staffing guideline [SG1]. London: NICE; 2014. URL: www​.nice.org.uk/guidance/sg1 (accessed September 2017).
9.
National Institute for Health and Care Excellence (NICE). Safe Midwifery Staffing for Maternity Settings. London; NICE: 2014.
10.
Lord Carter of Coles. Operational Productivity and Performance in English NHS Acute Hospitals: Unwarranted Variations. An Independent Report for the Department of Health. 2016. URL: www​.gov.uk/government​/uploads/system/uploads​/attachment_data​/file/499229/Operational_productivity_A​.pdf (accessed September 2017).
11.
Royal College of Nursing. Guidance on Safe Nurse Staffing Levels in The UK. London: Royal College of Nursing; 2010.
12.
The Shelford Group. Safer Nursing Care Tool. Implementation Resource Pack. London: The Shelford Group; 2013. URL: www​.nhsiq.nhs.uk/media​/2760784/130719_shelford​_safer_nursing_final.pdf (accessed September 2017).
13.
National Institute for Health and Care Excellence (NICE). Safe Staffing for Nursing in Adult Inpatient Wards in Acute Hospitals: Establishment Genie. London: NICE; 2017. URL: www​.nice.org.uk/about​/what-we-do/into-practice/endorsement (accessed September 2017).
14.
Ball J, Catton H. Planning nurse staffing: are we willing and able? J Res Nurs 2011;16:551–8. 10.1177/1744987111422425 [CrossRef]
15.
Lord Carter of Coles. Review of Operational Productivity in NHS Providers, Interim Report. 2015. URL: www​.hsj.co.uk/Journals​/2015/06/11/e/v/i/Lord-Carter-interim-report-June-2015.pdf (accessed September 2017).
16.
Buchan J, O’May F, Dussault G. Nursing workforce policy and the economic crisis: a global overview. J Nurs Scholarsh 2013;45:298–307. 10.1111/jnu.12028 [PubMed] [CrossRef]
17.
Buchan J, Seccombe I, Gershlick B, Charlesworth A. In Short Supply: Pay Policy and Nurse Numbers. London: The Health Foundation; 2017.
18.
Buchan J, Seccombe I. A Decisive Decade: The UK Nursing Labour Market Review. London: Royal College of Nursing; 2011.
19.
Universities and Colleges Admissions Service (UCAS). UK Application Rates by the January Deadline. Prestbury: UCAS; 2017. URL: www​.ucas.com/file/92746​/download?token=4Ij-BMlr (accessed September 2017).
20.
The King’s Fund. The Future is Now. London: The King’s Fund; 2015. URL: www​.kingsfund.org.uk​/reports/thefutureisnow/ (accessed September 2017).
21.
Scott C. Setting Safe Nurse Staffing Levels. An Exploration of the Issues. London: Royal College of Nursing; 2003.
22.
Kitson A, Wiechula R, Conroy T, Athlin AM, Whitaker N. The Future Shape of the Nursing Workforce: A Synthesis of the Evidence of Factors that Impact on Quality Nursing Care. Adelaide, SA: University of Adelaide; 2013.
23.
Ball JE, Griffiths P, Rafferty AM, Lindqvist R, Murrells T, Tishelman C. A cross-sectional study of ‘care left undone’ on nursing shifts in hospitals. J Adv Nurs 2016;72:2086–97. 10.1111/jan.12976 [PubMed] [CrossRef]
24.
McGillis Hall L, Doran D, Pink GH. Nurse staffing models, nursing hours, and patient safety outcomes. J Nurs Adm 2004;34:41–5. 10.1097/00005110-200401000-00009 [PubMed] [CrossRef]
25.
Kane R, Shamlyian T, Mueller C, Duval S, Wilt TJ. Nurse Staffing and Quality of Patient Care. Evidence Report/Technology Assessment. No 151. Rockville, MD: Agency for Healthcare Research and Quality; 2007.
26.
Trinier RM. Nursing Workload and its Relationship to Patient Care Error in the Paediatric Critical Care Setting. PhD thesis. Athabasca, AB: Athabasca University; 2016.
27.
Recio-Saucedo A, Pope C, Dall’Ora C, Griffiths P, Jones J, Crouch R, Drennan J. Safe staffing for nursing in emergency departments: evidence review. Emerg Med J 2015;32:888–94. 10.1136/emermed-2015-204936 [PubMed] [CrossRef]
28.
Griffiths P, Ball J, Drennan J, James l, Jones J, Recio-Saucedo A, et al. The Association Between Patient Safety Outcomes and Nurse Healthcare Assistant Skill Mix and Staffing Levels and Factors that May Influence Staffing Requirements. Southampton: Centre for Innovation and Leadership in Health Sciences, University of Southampton; 2014.
29.
Griffiths P, Ball J. Nurse Staffing Levels, Quality and Outcomes of Care in NHS Hospital Wards: What Does the Evidence Say? Southampton: University of Southampton Health Work Evidence Brief; 2017. URL: https://improvement​.nhs​.uk/uploads/documents​/Evidence_review.pdf (accessed September 2017).
30.
West E, Barron DN, Harrison D, Rafferty AM, Rowan K, Sanderson C. Nurse staffing, medical staffing and mortality in Intensive Care: an observational study. Int J Nurs Stud 2014;51:781–94. 10.1016/j.ijnurstu.2014.02.007 [PubMed] [CrossRef]
31.
Needleman J, Buerhaus P, Pankratz VS, Leibson CL, Stevens SR, Harris M. Nurse staffing and inpatient hospital mortality. N Engl J Med 2011;364:1037–45. 10.1056/NEJMsa1001025 [PubMed] [CrossRef]
32.
Aiken LH, Sloane DM, Bruyneel L, Van den Heede K, Griffiths P, Busse R, et al. Nurse staffing and education and hospital mortality in nine European countries: a retrospective observational study. Lancet 2014;383:1824–30. 10.1016/S0140-6736(13)62631-8 [PMC free article] [PubMed] [CrossRef]
33.
Twigg D, Duffield C, Bremner A, Rapley P, Finn J. Impact of skill mix variations on patient outcomes following implementation of nursing hours per patient day staffing: a retrospective study. J Adv Nurs 2012;68:2710–18. 10.1111/j.1365-2648.2012.05971.x [PubMed] [CrossRef]
34.
Griffiths P, Ball J, Murrells T, Jones S, Rafferty AM. Registered nurse, healthcare support worker, medical staffing levels and mortality in English hospital trusts: a cross-sectional study. BMJ Open 2016;6:e008751. 10.1136/bmjopen-2015-008751 [PMC free article] [PubMed] [CrossRef]
35.
Twigg D, Duffield C, Bremner A, Rapley P, Finn J. The impact of the nursing hours per patient day (NHPPD) staffing method on patient outcomes: a retrospective analysis of patient and staffing data. Int J Nurs Stud 2011;48:540–8. 10.1016/j.ijnurstu.2010.07.013 [PubMed] [CrossRef]
36.
Ball JE, Murrells T, Rafferty AM, Morrow E, Griffiths P. ‘Care left undone’ during nursing shifts: associations with workload and perceived quality of care. BMJ Qual Saf 2014;23:116–25. 10.1136/bmjqs-2012-001767 [PMC free article] [PubMed] [CrossRef]
37.
Australian Nursing Federation. Why Investing in Nursing Makes Sense. Issues Paper. Melbourne, VIC: Australian Nursing Federation; 2009.
38.
NHS England. Safer Staffing: A Guide to Care Contact Time. London: Chief Nursing Officer England, NHS England; 2014. URL: www​.england.nhs.uk/wp-content​/uploads/2014​/11/safer-staffing-guide-care-contact-time.pdf (accessed September 2017).
39.
Savitz LA, Jones CB, Bernard S. Quality Indicators Sensitive to Nurse Staffing. In Henriksen K, Battles JB, Marks ES, Lewin DI, editors. Acute Care Settings. Advances in Patient Safety. Rockville, MO, USA: Agency for Healthcare Research and Quality; 2005.
40.
Rafferty AM, Clarke SP, Coles J, Ball J, James P, McKee M, Aiken LH. Outcomes of variation in hospital nurse staffing in English hospitals: cross-sectional analysis of survey data and discharge records. Int J Nurs Stud 2007;44:175–82. 10.1016/j.ijnurstu.2006.08.003 [PMC free article] [PubMed] [CrossRef]
41.
Jones TL, Hamilton P, Murry N. Unfinished nursing care, missed care, and implicitly rationed care: state of the science review. Int J Nurs Stud 2015;52:1121–37. 10.1016/j.ijnurstu.2015.02.012 [PubMed] [CrossRef]
42.
Manias E, Aitken R, Peerson A, Parker J, Wong K. Agency-nursing work: perceptions and experiences of agency nurses. Int J Nurs Stud 2003;40:269–79. 10.1016/S0020-7489(02)00085.8 [PubMed] [CrossRef]
43.
Aiken LH, Xue Y, Clarke SP, Sloane DM. Supplemental nurse staffing in hospitals and quality of care. J Nurs Adm 2007;37:335–42. 10.1097/01.NNA.0000285119.53066.ae [PMC free article] [PubMed] [CrossRef]
44.
Dall’Ora C, Griffiths P. Flexible Nurse Staffing in Hospital Wards: The Effects on Costs and Patient Outcomes? Southampton: University of Southampton Health Work Evidence Brief; 2017. URL: https://improvement​.nhs​.uk/uploads/documents​/Evidence_review.pdf (accessed September 2017).
45.
Bruyneel L, Li B, Ausserhofer D, Lesaffre E, Dumitrescu I, Smith HL, et al. Organization of hospital nursing, provision of nursing care, and patient experiences with care in Europe. Med Care Res Rev 2015;72:643–64. 10.1177/1077558715589188 [PMC free article] [PubMed] [CrossRef]
46.
Dall’Ora C, Griffiths P. Nursing Shift Work in Hospitals What Are the Effects on Patient and Employee Outcomes? Southampton: University of Southampton Health Work Evidence Brief; 2017. URL: https://improvement​.nhs​.uk/uploads/documents​/Evidence_review.pdf (accessed September 2017).
47.
Ball J, Day T, Murrells T, Dall’Ora C, Rafferty AM, Griffiths P, Maben J. Cross-sectional examination of the association between shift length and hospital nurses job satisfaction and nurse reported quality measures. BMC Nurs 2017;16:26. 10.1186/s12912-017-0221-7 [PMC free article] [PubMed] [CrossRef]
48.
Kane R, Shamlyian T, Mueller C. The association of registered nurse staffing levels and patient outcomes. Med Care 2007;45:95–1204. 10.1097/MLR.0b013e3181468ca3 [PubMed] [CrossRef]
49.
Simon M, Ball J, Drennan J, Jones J, Recio-Saucedo A, Griffiths P. Effectiveness of Management Approaches and Organisational Factors on Nurse Staffing Sensitive Outcomes. Southampton: Centre for Innovation and Leadership in Health Sciences, University of Southampton; 2014.
50.
Butler M, Collins R, Drennan J, Halligan P, O’Mathúna DP, Schultz TJ, et al. Hospital nurse staffing models and patient and staff-related outcomes. Cochrane Database Syst Rev 2011;7:CD007019. 10.1002/14651858.CD007019.pub2 [PubMed] [CrossRef]
51.
Blegen MA, Vaughn T, Vojir CP. Nurse staffing levels: impact of organizational characteristics and registered nurse supply. Health Serv Res 2008;43:154–73. 10.1111/j.1475-6773.2007.00749.x [PMC free article] [PubMed] [CrossRef]
52.
Hurst K. UK ward design: patient dependency, nursing workload, staffing and quality – an observational study. Int J Nurs Stud 2008;45:370–81. 10.1016/j.ijnurstu.2006.09.007 [PubMed] [CrossRef]
53.
Bowers L, Crowder M. Nursing staff numbers and their relationship to conflict and containment rates on psychiatric wards – a cross sectional time series poisson regression study. Int J Nurs Stud 2012;49:15–20. 10.1016/j.ijnurstu.2011.07.005 [PubMed] [CrossRef]
54.
Lawes A, Marcus L, Piling S. What Staffing Structures of Mental Health Services Are Associated with Improved Patient Outcomes? Safe, Sustainable Staffing/National Collaborating Centre for Mental Health; 2017. URL: https://improvement​.nhs​.uk/uploads/documents​/NCCMH_Literature​_Review_Mental_Health_Final.pdf (accessed September 2017).
55.
Mafuba K, Gates B, Sivasubramanian M. Report of a Mixed Methods Systematic Review of the Literature to Inform the Development of Safe Sustainable Staffing Improvement Resource in Learning Disability (LD) Services for NHS Improvement. London: University of West London and NHS improvement; 2016. URL: https://improvement​.nhs​.uk/uploads/documents​/LD_evidence_review.pdf (accessed September 2017).
56.
Jackson C, Wright T, Martin A. Safe Caseloads for Adult Community Nursing Services – An Updated Review of the Evidence. Canterbury Christ Church University and NHS Improvement; 2016. https://improvement​.nhs​.uk/uploads/documents​/Final_Version_Managing​_Safe_Caseloads.pdf (accessed September 2017).
57.
Mitchell G, Cousins C, Burrows R, Cousins G. A review of safe-staffing models and their applicability to care homes. J Nurs Manag 2017;25:157–62. 10.1111/jonm.12450 [PubMed] [CrossRef]
58.
Mark B, Harless DW, Spetz J. California’s minimum-nurse-staffing legislation and nurses’ wages. Health Aff 2009;28:w326–34. 10.1377/hlthaff.28.2.w326 [PubMed] [CrossRef]
59.
Twigg DE, Myers H, Duffield C, Giles M, Evans G. Is there an economic case for investing in nursing care – what does the literature tell us? J Adv Nurs 2015;71:975–90. 10.1111/jan.12577 [PMC free article] [PubMed] [CrossRef]
60.
Needleman J, Buerhaus PI, Stewart M, Zelevinsky K, Mattke S. Nurse staffing in hospitals: is there a business case for quality? Health Aff 2006;25:204–11. 10.1377/hlthaff.25.1.204 [PubMed] [CrossRef]
61.
NHS Providers. The State of the NHS Provider Sector. London: NHS Providers; 2016. URL: www​.nhsproviders.org​/media/2479/the-state-of-the-nhs-provider-sector-november-2016.pdf (accessed September 2017).
62.
Smeds Alenius L, Tishelman C, Runesdotter S, Lindqvist R. Staffing and resource adequacy strongly related to RNs’ assessment of patient safety: a national study of RNs working in acute-care hospitals in Sweden. BMJ Qual Saf 2014;23:242–9. 10.1136/bmjqs-2012-001734 [PMC free article] [PubMed] [CrossRef]
63.
Louch G, O’Hara J, Gardner P, O’Connor DB. The daily relationships between staffing, safety perceptions and personality in hospital nursing: a longitudinal on-line diary study. Int J Nurs Stud 2016;59:27–37. 10.1016/j.ijnurstu.2016.02.010 [PubMed] [CrossRef]
64.
Heinen MM, van Achterberg T, Schwendimann R, Zander B, Matthews A, Kózka M, et al. Nurses’ intention to leave their profession: a cross sectional observational study in 10 European countries. Int J Nurs Stud 2013;50:174–84. 10.1016/j.ijnurstu.2012.09.019 [PubMed] [CrossRef]
65.
Bakker D, Conlon M, Fitch M, Green E, Butler L, Olson K, Cummings G. Canadian oncology nurse work environments: part I. Nurs Leadersh 2010;22:50–68. 10.12927/cjnl.2010.21597 [PubMed] [CrossRef]
66.
Papastavrou E, Andreou P, Vryonides S. The hidden ethical element of nursing care rationing. Nurs Ethics 2014;21:583–93. 10.1177/0969733013513210 [PubMed] [CrossRef]
67.
Hahtela N, Paavilainen E, McCormack B, Slater P, Helminen M, Suominen T. Influence of workplace culture on nursing-sensitive nurse outcomes in municipal primary health care. J Nurs Manag 2015;23:931–9. 10.1111/jonm.12237 [PubMed] [CrossRef]
68.
Dziuba-Ellis J. Float pools and resource teams: a review of the literature. J Nurs Care Qual 2006;21:352–9. 10.1097/00001786-200610000-00013 [PubMed] [CrossRef]
69.
Aiken LH, Sloane DM, Cimiotti JP, Clarke SP, Flynn L, Seago JA, et al. Implications of the California nurse staffing mandate for other states. Health Serv Res 2010;45:904–21. 10.1111/j.1475-6773.2010.01114.x [PMC free article] [PubMed] [CrossRef]
70.
Aiken LH, Clarke SP, Sloane DM, International Hospital Outcomes Research Consortium. Hospital staffing, organization, and quality of care: cross-national findings. Int J Qual Health Care 2002;14:5–13. 10.1093/intqhc/14.1.5 [PubMed] [CrossRef]
71.
Ausserhofer D, Schubert M, Desmedt M, Blegen MA, De Geest S, Schwendimann R. The association of patient safety climate and nurse-related organizational factors with selected patient outcomes: a cross-sectional survey. Int J Nurs Stud 2013;50:240–52. 10.1016/j.ijnurstu.2012.04.007 [PubMed] [CrossRef]
72.
Kenward L, Whiffin C, Spalek B. Feeling unsafe in the healthcare setting: patients’ perspectives. Br J Nurs 2017;26:143–9. 10.12968/bjon.2017.26.3.143 [PubMed] [CrossRef]
73.
The Patients Association Response to the National Assembly for Wales on the Issue of Safe Nurse Staffing Levels. 2015. URL: www​.patients-association​.org.uk/.../2015/​.../Patients-Association-Welsh-Assembly (accessed September 2017).
74.
Martin GP, Chew S, Palser TR. The personal and the organisational perspective on iatrogenic harm: bridging the gap through reconciliation processes. BMJ Qual Saf 2017;0:1–3. 10.1136/bmjqs-2017-006914 [PubMed] [CrossRef]
75.
Great Britain. Health and Social Care Act. Regs 2014. Regulation 18: Staffing. London: The Stationery Office; 2014.
76.
NHS England. Guidance Issued on Hard Truths Commitments Regarding the Publishing of Staffing Data. London: NHS England; 2014. URL: www​.england.nhs.uk/2014/04/hard-truths/ (accessed September 2017).
77.
Great Britain. Nurse Staffing Levels (Wales) Act 2016. No. 829 (Wales 208) (Chapter 59). London: The Stationery Office; 2016.
78.
NHS Scotland. Safe and Effective Staffing in Health and Social Care. Executive Summary. Edinburgh: NHS Scotland; 2017. URL: www​.gov.scot/Publications/2017/04/1188/1 (accessed September 2017).
79.
Royal College of Nursing. Mandatory Nurse Staffing Levels. London: Royal College of Nursing; 2012.
80.
Donaldson N, Shapiro S. Impact of California mandated acute care hospital nurse staffing ratios: a literature synthesis. Policy Polit Nurs Pract 2010;11:184–201. 10.1177/1527154410392240 [PubMed] [CrossRef]
81.
Burnes Bolton L, Aydin CE, Donaldson N, Brown DS, Sandhu M, Fridman M, Aronow HU. Mandated nurse staffing ratios in California: a comparison of staffing and nursing-sensitive outcomes pre- and postregulation. Policy Polit Nurs Pract 2007;8:238–50. 10.1177/1527154407312737 [PubMed] [CrossRef]
82.
The King’s Fund. What Has the Impact Been of Recent Caps on NHS Agency Staff Spend? London: The King’s Fund; 2016. URL: www​.kingsfund.org.uk​/blog/2016/03/nhs-agency-staff-spend (accessed September 2017).
83.
NHS Improvement. Safe Staffing for Adult Inpatients in Acute Care: A Guide to Help Standardise Staffing Decisions in Adult Inpatient Wards in Acute Hospitals. London: NHS Improvement; 2016. URL: https://improvement​.nhs​.uk/resources/safe-staffing-improvement-resources-adult-inpatient-acute-care/ (accessed September 2017).
84.
National Quality Board (NQB). Safe, Sustainable and Productive Staffing: An Improvement Resource for Learning Disability Services. London: NQB; 2017. URL: https://improvement​.nhs​.uk/uploads/documents​/Learning_Disability​_safe__sustainable_staffing.pdf (accessed September 2017).
85.
National Quality Board (NQB). Safe, Sustainable and Productive Staffing: An Improvement Resource for Mental Health. London: NQB; 2017. URL: https://improvement​.nhs​.uk/uploads/documents​/Mental_Health_Setting​_Improvement_Resource_Engagement​.pdf (accessed September 2017).
86.
National Quality Board (NQB). Safe, Sustainable and Productive Staffing: An Improvement Resource for the District Nursing Service. London: NQB; 2017. URL: https://improvement​.nhs​.uk/uploads/documents​/Community_safe_​_edit_v30_proofed_final.pdf (accessed September 2017).
87.
Department of Health, Social Services and Public Safety. Delivering Care: Nurse Staffing in Northern Ireland. Section 1. Belfast: Department of Health, Social Services and Public Safety; 2014. URL: www​.publichealth.hscni​.net/sites/default​/files/dc-section1%5B1​%5D%20FINAL%20PDF_0.pdf (accessed 4 August 2017).
88.
NHS Scotland. Workforce Planning. URL: www​.knowledge.scot.nhs​.uk/workforceplanning​/resources/nursing-and-midwifery-workload-and-workforce-planning-tools.aspx (accessed September 2017).
89.
Rycroft-Malone J, Burton CR, Williams L, Edwards S, Fisher D, McCormack B, et al. Improving skills and care standards in the support workforce for older people: a realist synthesis of workforce development interventions. Health Serv Deliv Res 2016;4(12). [PMC free article] [PubMed]
90.
The Health Foundation. In Short Supply: Pay Policy and Nurse Numbers – Nurse Staffing. London: The Health Foundation; 2017.
91.
McCormack B, Rycroft-Malone J, Decorby K, Hutchinson AM, Bucknall T, Kent B, et al. A realist review of interventions and strategies to promote evidence-informed healthcare: a focus on change agency. Implement Sci 2013;8:107. 10.1186/1748-5908-8-107 [PMC free article] [PubMed] [CrossRef]
92.
Pawson R, Tilley N. Realistic Evaluation. London: Sage Publications; 1997.
93.
Wong G, Greenhalgh T, Westhorp G, Buckingham J, Pawson R. RAMESES publication standards: realist syntheses. J Adv Nurs 2013;69:1005–1022. 10.1111/jan.12095 [PubMed] [CrossRef]
94.
Pawson R. Evidence-based Policy: A Realist Perspective. London: Sage Publications; 2006. 10.4135/9781849209120 [CrossRef]
95.
Post JE, Preston LE, Sachs S. Managing the extended enterprise: the new stakeholder view. Calif Manag Rev 2002;45:6–28. 10.2307/41166151 [CrossRef]
96.
Rycroft-Malone J, McCormack B, Hutchinson AM, DeCorby K, Bucknall TK, Kent B, et al. Realist synthesis: illustrating the method for implementation research. Implement Sci 2012;7:33. 10.1186/1748-5908-7-33 [PMC free article] [PubMed] [CrossRef]
97.
Greenhalgh T, Wong G, Westhorp G, Pawson R. Protocol – realist and meta-narrative evidence synthesis: evolving standards (RAMESES). BMC Med Res Methodol 2011;11:115. 10.1186/1471-2288-11-115 [PMC free article] [PubMed] [CrossRef]
98.
Nutley SM, Walter I, Davies HT. Using Evidence: How Research Can Inform Public Services. Bristol: Policy Press; 2007. 10.2307/j.ctt9qgwt1 [CrossRef]
99.
Malloch K, Conovaloff A. Patient classification systems, part 1: the third generation. J Nurs Adm 1999;29:49–56. 10.1097/00005110-199907000-00013 [PubMed] [CrossRef]
100.
Van Slyck A, Johnson KR. Using patient acuity data to manage patient care outcomes and patient care costs. Outcomes Manag Nurs Pract 2001;5:36–40. [PubMed]
101.
Allen D. The Invisible Work of Nurses: Hospitals, Organisation and Healthcare. New York, NY: Routledge; 2014.
102.
Villarreal MC, Keskinocak P. Staff planning for operating rooms with different surgical services lines. Health Care Manag Sci 2016;19:144–69. 10.1007/s10729-014-9307-x [PubMed] [CrossRef]
103.
Sibbald B, Shen J, McBride A. Changing the skill-mix of the health care workforce. J Health Serv Res Policy 2004;9(Suppl. 1):28–38. 10.1258/135581904322724112 [PubMed] [CrossRef]
104.
Burke EK, De Causmaecker P, Berghe GV, Van Landeghem H. The state of the art of nurse rostering. J Scheduling 2004;7:441–99. 10.1023/B:JOSH.0000046076.75950.0b [CrossRef]
105.
Duffield C, Diers D, O’Brien-Pallas L, Aisbett C, Roche M, King M, Aisbett K. Nursing staffing, nursing workload, the work environment and patient outcomes. Appl Nurs Res 2011;24:244–55. 10.1016/j.apnr.2009.12.004 [PubMed] [CrossRef]
106.
Blay N, Duffield CM, Gallagher R, Roche M. Methodological integrative review of the work sampling technique used in nursing workload research. J Adv Nurs 2014;70:2434–49. 10.1111/jan.12466 [PubMed] [CrossRef]
107.
Boxall P, Purcell J. Strategy and Human Resource Management. Basingstoke: Palgrave Macmillan; 2011.
108.
World Health Organization. Working Together for Health: The World Health Report. Geneva: World Health Organization; 2006.
109.
Rogers EM. Diffusion of Innovations. New York, NY: Free Press; 2003.
110.
Thompson C, Dowding D. Clinical Decision Making and Judgement in Nursing. London: Churchill Livingstone; 2009.
111.
Easterby-Smith M. Disciplines of organizational learning: contributions and critiques. Hum Relat 1997;50:1085–113. 10.1177/001872679705000903 [CrossRef]
112.
Raelin JA. Work-based learning in practice. J Workplace Learn 1998;10:280–3. 10.1108/13665629810236183 [CrossRef]
113.
Dewing J. Becoming and Being Active Learners and Creating Active Learning Workplaces: The Value of Active Learning. In McCormack B, Manley K, Wilson V, editors. International Practice Development in Nursing and Healthcare. Oxford: Oxford Blackwell; 2008. pp. 273–94.
114.
French B, Thomas LH, Baker P, Burton CR, Pennington L, Roddam H. What can management theories offer evidence-based practice? A comparative analysis of measurement tools for organisational context. Implement Sci 2009;4:28. 10.1186/1748-5908-4-28 [PMC free article] [PubMed] [CrossRef]
115.
Rycroft-Malone J, Harvey G, Seers K, Kitson A, McCormack B, Titchen A. An exploration of the factors that influence the implementation of evidence into practice. J Clin Nurs 2004;13:913–24. 10.1111/j.1365-2702.2004.01007.x [PubMed] [CrossRef]
116.
Ferlie E, Crilly T, Jashapara A, Trenholm S, Peckham A, Currie G. Knowledge mobilization in healthcare organizations: a view from the resource-based view of the firm. Int J Health Policy Manag 2015;4:127–30. 10.15171/ijhpm.2015.35 [PMC free article] [PubMed] [CrossRef]
117.
Crilly T, Jashapara A, Trenholm S, Peckham A, Currie G, Ferlie E. Knowledge Mobilisation in Healthcare Organisations: Synthesising Evidence and Theory Using Perspectives of Organisational Form, Resource Based View of the Firm and Critical Theory. Southampton: National Institute for Health Research Health Services and Delivery Research programme; 2013.
118.
Kooker BM, Kamikawa C. Successful strategies to improve RN retention and patient outcomes in a large medical centre in Hawaii. J Clin Nurs 2011;20:34–9. 10.1111/j.1365-2702.2010.03476.x [PubMed] [CrossRef]
119.
Lacey SR, Cox KS, Lorfing KC, Teasley SL, Carroll CA, Sexton K. Nursing support, workload, and intent to stay in Magnet, Magnet-aspiring, and non-Magnet hospitals. J Nurs Adm 2007;37:199–205. 10.1097/01.NNA.0000266839.61931.b6 [PubMed] [CrossRef]
120.
Kalisch BJ, Xie B, Ronis DL. Train-the-trainer intervention to increase nursing teamwork and decrease missed nursing care in acute care patient units. Nurs Res 2013;62:405–13. 10.1097/NNR.0b013e3182a7a15d [PubMed] [CrossRef]
121.
Fairbrother G, Jones A, Rivas K. Changing model of nursing care from individual patient allocation to team nursing in the acute inpatient environment. Contemp Nurse 2010;35:202–20. 10.5172/conu.2010.35.2.202 [PubMed] [CrossRef]
122.
Tran DT, Johnson M, Fernandez R, Jones S. A shared care model vs. a patient allocation model of nursing care delivery: comparing nursing staff satisfaction and stress outcomes. Int J Nurs Pract 2010;16:148–58. 10.1111/j.1440-172X.2010.01823.x [PubMed] [CrossRef]
123.
Dubois CA, D’amour D, Tchouaket E, Clarke S, Rivard M, Blais R. Associations of patient safety outcomes with models of nursing care organization at unit level in hospitals. Int J Qual Health Care 2013;25:110–17. 10.1093/intqhc/mzt019 [PubMed] [CrossRef]
124.
van Oostveen CJ, Ubbink DT, Mens MA, Pompe EA, Vermeulen H. Pre-implementation studies of a workforce planning tool for nurse staffing and human resource management in university hospitals. J Nurs Manag 2016;24:184–91. 10.1111/jonm.12297 [PubMed] [CrossRef]
125.
Anderson MH, Lønning K, Fagerström L. Testing reliability and validity of the Oulu patient classification instrument – the first step in evaluating the RAFAELA system in Norway. Open J Nurs 2014;4:303–11. 10.4236/ojn.2014.44035 [CrossRef]
126.
Robinson CH, Annis AM, Form ANJ, Krein SL, Yankey N, Duffy SA, et al. Factors that affect implementation of a nurse staffing directive: results from a qualitative multi-case evaluation. J Adv Nurs 2016;72:1886–98. 10.1111/jan.12961 [PubMed] [CrossRef]
127.
Taylor B, Yankey N, Robinson C, Annis A, Haddock KS, Alt-White A, et al. Evaluating the Veterans Health Administration’s staffing methodology model: a reliable approach. Nurs Econ 2015;33:36–40, 66. [PubMed]
128.
Subirana M, Long A, Greenhalgh J, Firth J. A realist logic model of the links between nurse staffing and the outcomes of nursing. J Res Nurs 2014;19:8–23. 10.1177/1744987113481782 [CrossRef]
129.
McIntyre L. Good Practice Guide: Rostering. NHS Improvement guidance; 2016. URL: https://improvement​.nhs​.uk/uploads/documents​/Rostering_Good_Practice​_Guidance_Final_v2.pdf (accessed September 2017).
130.
Dent B. Nine principles for improved nurse staffing. Nurs Econ 2015;33:41–4, 66. [PubMed]
131.
NHS Education for Scotland. Nursing and Midwifery Workload and Workforce Planning Learning Toolkit. 2nd edition. Edinburgh: NHS Education for Scotland; 2013.
132.
van Oostveen CJ, Mathijssen E, Vermeulen H. Nurse staffing issues are just the tip of the iceberg: a qualitative study about nurses’ perceptions of nurse staffing. Int J Nurs Stud 2015;52:1300–9. 10.1016/j.ijnurstu.2015.04.002 [PubMed] [CrossRef]
133.
Harris A, McGillis Hall L. Evidence to Inform Staff Mix Decision-Making: A Focused Literature Review. Ottawa, ON: Canadian Nurses Association; 2012.
134.
Anderson EF, Frith KH, Caspers B. Linking economics and quality: developing an evidence-based nurse staffing tool. Nurs Adm Q 2011;35:53–60. 10.1097/NAQ.0b013e3182047dff [PubMed] [CrossRef]
135.
Checkland P. Systems Thinking, Systems Practice. Chichester: John Wiley & Sons; 1999.
136.
Dopson S, Fitzgerald L. Knowledge to Action? Evidence-Based Healthcare In Context. Oxford; Oxford University Press: 2005.
137.
Dalkin S, Lhussier M, Williams L, Burton CR, Rycroft-Malone J. Exploring the use of Soft Systems Methodology with realist approaches: a novel way to map programme complexity and develop and refine programme theory. Evaluation 2018;24:84–7. 10.1177/1356389017749036 [CrossRef]
138.
Rudd L, Watkins A, Wyatt M, Jones A. All Wales Mental Health Acuity Programmes: Results of a National Pilot. Presented to the All Wales Mental Health Senior Nurse Advisory Group, 20 March 2016.
139.
Griffiths R. NHS Management Inquiry Report. London: Department of Health and Social Services; 1983.
140.
Meyer SB, Lunnay B. The application of abductive and retroductive inference for the design and analysis of theory-driven sociological research. Sociol Res Online 2012;18:1–11. 10.5153/sro.2819 [CrossRef]
141.
Bucknall T, Aitken L. Think Aloud Technique. In Gerrish K, Lacey A, editors. The Research Process in Nursing. 6th edn. London: John Wiley & Sons; 2010. pp. 395–407.
142.
Payne JW. Thinking aloud: insights into information processing. Psychol Sci 1994;5:241–8. 10.1111/j.1467-9280.1994.tb00620.x [CrossRef]
143.
Drake RG. The nurse rostering problem: from operational research to organizational reality? J Adv Nurs 2014;70:800–10. 10.1111/jan.12238 [PubMed] [CrossRef]
144.
Hall LM, Pink L, Lalonde M, Murphy GT, O’Brien-Pallas L, Laschinger HK, et al. Decision making for nurse staffing: Canadian perspectives. Policy Polit Nurs Pract 2006;7:261–9. 10.1177/1527154406297799 [PubMed] [CrossRef]
145.
Effken JA, Brewer BB, Logue MD, Gephart SM, Verran JA. Using Cognitive Work Analysis to fit decision support tools to nurse managers’ work flow. Int J Med Inform 2011;80:698–707. 10.1016/j.ijmedinf.2011.07.003 [PMC free article] [PubMed] [CrossRef]
146.
Fasoli DR, Fincke BG, Haddock KS. Going beyond patient classification systems to create an evidence-based staffing methodology. J Nurs Adm 2011;41:434–9. 10.1097/NNA.0b013e31822edd8e [PubMed] [CrossRef]
147.
Fenton K, Casey A. A tool to calculate safe nurse staffing levels. Nurs Times 2015;111:12–14. [PubMed]
148.
Eduardo EA, Peres AM, de Almeida Mde L, Roglio Kde D, Bernardino E. Analysis of the decision-making process of nurse managers: a collective reflection. Rev Bras Enferm 2015;68:–, 668–75. 10.1590/0034-7167.2015680414i [PubMed] [CrossRef]
149.
Connelly LM, Yoder LH, Miner-Williams D. A qualitative study of charge nurse competencies. Medsurg Nurs 2003;12:298–305. [PubMed]
150.
Wilson DS, Talsma A, Martyn K. Mindful staffing: a qualitative description of charge nurses’ decision-making behaviors. West J Nurs Res 2011;33:805–24. 10.1177/0193945910396519 [PubMed] [CrossRef]
151.
Kontio E, Lundgren-Laine H, Kontio J, Korvenranta H, Salanterä S. Information utilization in tactical decision making of middle management health managers. Comput Inform Nurs 2013;31:9–16. 10.1097/NXN.0b013e318261f192 [PubMed] [CrossRef]
152.
Berkow S, Jaggi T, Fogelson R, Katz S, Hirschoff A. Fourteen unit attributes to guide staffing. J Nurs Adm 2007;37:150–5. 10.1097/01.NNA.0000262737.00662.f9 [PubMed] [CrossRef]
153.
Wilson JM, Weiss A. Police staffing allocation and managing workload demand: a critical assessment of existing practices. Policing 2014;8:96–108. 10.1093/police/pau002 [CrossRef]
154.
Diers D, Torre C Jr, Heard DM, Bozzo J, O’Brien W. Bringing decision support to nurse managers. Comput Nurs 2000;18:137–44. [PubMed]
155.
Bonner R, Beaumont R, Smith B. Understanding rostering. Part 1. The rights and wrongs of rostering. Aust Nurs J 1995;2:18–20. [PubMed]
156.
Bonner R, Beaumont R, Smith B. Understanding rostering. Part 2. The rights and wrongs of rostering. Aust Nurs J 1995;2:28–31. [PubMed]
157.
Bonner R, Beaumont R, Smith B. Understanding rostering. Part 3. How a roster is developed. Aust Nurs J 1995;2:40–2. [PubMed]
158.
Allen SB. The Nurse–Patient Assignment: Purposes, Decision Factors and Steps of the Process. PhD thesis. Columbia, SC: University of South Carolina; 2012.
159.
Siirala E, Peltonen LM, Lundgrén-Laine H, Salanterä S, Junttila K. Nurse managers’ decision-making in daily unit operation in peri-operative settings: a cross-sectional descriptive study. J Nurs Manag 2016;24:806–15. 10.1111/jonm.12385 [PubMed] [CrossRef]
160.
Rischbieth A. Matching nurse skill with patient acuity in the intensive care units: a risk management mandate. J Nurs Manag 2006;14:397–404. 10.1111/j.1365-2934.2006.00622.x [PubMed] [CrossRef]
161.
Wyatt M, Healey K. Managing capacity and workload in children’s services. Paediatr Nurs 2005;17:31–4. 10.7748/paed2005.07.17.6.31.c1031 [PubMed] [CrossRef]
162.
Drake RG. The ‘Robust’ roster: exploring the nurse rostering process. J Adv Nurs 2014;70:2095–106. 10.1111/jan.12367 [PubMed] [CrossRef]
163.
Cathro H. A practical guide to making patient assignments in acute care. J Nurs Adm 2013;43:6–9. 10.1097/NNA.0b013e3182785fff [PubMed] [CrossRef]
164.
Allen SB. The nurse–patient assignment: purposes and decision factors. J Nurs Adm 2015;45:628–35. 10.1097/NNA.0000000000000276 [PubMed] [CrossRef]
165.
Flynn M, McKeown M. Nurse staffing levels revisited: a consideration of key issues in nurse staffing levels and skill mix research. J Nurs Manag 2009;17:759–66. 10.1111/j.1365-2834.2009.01023.x [PubMed] [CrossRef]
166.
Hockley T, Boyle S. NHS Safe Staffing: Not Just a Number. London: London School of Economics and Political Science; 2014.
167.
Kerr F, Timony Y. Review of an automated rostering system from a nurse manager’s perspective. Stud Health Technol Inform 2009;146:96–102. [PubMed]
168.
Barton NS. Matching nurse staffing to demand. Nurs Manage 2011;42:36–9. 10.1097/01.NUMA.0000392986.20185.fa [PubMed] [CrossRef]
169.
Crist-Grundman D, Mulrooney G. Effective workforce management starts with leveraging technology, while staffing optimization requires true collaboration. Nurs Econ 2011;29:195–200. [PubMed]
170.
deSilva A, Smith K, Jayawardena S. Demand a staff scheduling system that is easy to use, empowers your staff, AND slashes budgets! CARING Newsletter 2005;20:6–11.
171.
Ruland CM. Developing a decision support system to meet nurse managers’ information needs for effective resource management. Comput Nurs 2001;19:187–93. [PubMed]
172.
Ruland CM, Ravn IH. Usefulness and effects on costs and staff management of a nursing resource management information system. J Nurs Manag 2003;11:208–15. 10.1046/j.1365-2834.2003.00381.x [PubMed] [CrossRef]
173.
Botter ML. The use of information generated by a patient classification system. J Nurs Adm 2000;30:544–51. 10.1097/00005110-200011000-00010 [PubMed] [CrossRef]
174.
Fram N, Morgan B. Ontario: linking nursing outcomes, workload and staffing decisions in the workplace: the Dashboard Project. Nurs Leadersh 2012;25:114–25. 10.12927/cjnl.2012.22801 [PubMed] [CrossRef]
175.
Pruinelli L, Delaney CW, Garciannie A, Caspers B, Westra BL. Nursing management minimum data set: cost-effective tool to demonstrate the value of nurse staffing in the big data science era. Nurs Econ 2016;34:66–71, 89. [PubMed]
176.
Pappas S, Davidson N, Woodard J, Davis J, Welton JM. Risk-adjusted staffing to improve patient value. Nurs Econ 2015;33:73–8, 87. [PubMed]
177.
Carter KF, Burnette HD. Creating patient–nurse synergy on a medical–surgical unit. Medsurg Nurs 2011;20:249–54. [PubMed]
178.
van Oostveen CJ, Braaksma A, Vermeulen H. Developing and testing a computerized decision support system for nurse-to-patient assignment: a multimethod study. Comput Inform Nurs 2014;32:276–85. 10.1097/CIN.0000000000000056 [PubMed] [CrossRef]
179.
Kane K. Capturing district nursing through a knowledge-based electronic caseload analysis tool (eCAT). Br J Community Nurs 2014;19:, 118–24. 10.12968/bjcn.2014.19.3.116 [PubMed] [CrossRef]
180.
Hyun S, Bakken S, Douglas K, Stone PW. Evidence-based staffing: potential roles for informatics. Nurs Econ 2008;26:151–8, 173. [PMC free article] [PubMed]
181.
Nagy KA, Nathan SK. Scheduling out of control? Consider workforce management options. Nurs Manage 2010;41:52–3. 10.1097/01.NUMA.0000388301.69975.df [PubMed] [CrossRef]
182.
Kivinen T, Lammintakanen J. The success of a management information system in health care – a case study from Finland. Int J Med Inform 2013;82:90–7. 10.1016/j.ijmedinf.2012.05.007 [PubMed] [CrossRef]
183.
Frith KH, Anderson F, Sewell JP. Assessing and selecting data for a nursing services dashboard. J Nurs Adm 2010;40:10–16. 10.1097/NNA.0b013e3181c47d45 [PubMed] [CrossRef]
184.
Maenhout B, Vanhoucke M. Analyzing the nursing organizational structure and process from a scheduling perspective. Health Care Manag Sci 2013;16:177–96. 10.1007/s10729-013-9222-6 [PubMed] [CrossRef]
185.
Silvestro R, Silvestro C. Towards a model of Strategic Roster Planning and Control: an empirical study of nurse rostering practices in the UK National Health Service. Health Serv Manage Res 2008;21:93–105. 10.1258/hsmr.2008.007025 [PubMed] [CrossRef]
186.
Murtola L-M, Lundgrén-Laine H, Salanterä S. Information systems in hospitals: a review article from a nursing management perspective. Int J Networking and Virtual Organisations 2013;13:81–100. 10.1504/IJNVO.2013.058441 [CrossRef]
187.
Shirey MR, Ebright PR, McDaniel AM. Nurse manager cognitive decision-making amidst stress and work complexity. J Nurs Manag 2013;21:17–30. 10.1111/j.1365-2834.2012.01380.x [PubMed] [CrossRef]
188.
Zori S, Nosek LJ, Musil CM. Critical thinking of nurse managers related to staff RNs’ perceptions of the practice environment. J Nurs Scholarsh 2010;42:305–13. 10.1111/j.1547-5069.2010.01354.x [PubMed] [CrossRef]
189.
Davidhizar R, Dowd SB, Brownson K. An equitable nursing assignment structure. Nurs Manage 1998;29:33–5. 10.1097/00006247-199804000-00010 [PubMed] [CrossRef]
190.
Valentine NM, Nash J, Hughes D, Douglas K. Achieving effective staffing through a shared decision-making approach to open-shift management. J Nurs Adm 2008;38:331–5. 10.1097/01.NNA.0000323941.04888.ed [PubMed] [CrossRef]
191.
Brown EV. Shifting priorities. A Georgia healthcare enterprise uses bid shifting technology to reduce agency labor costs and maximize nurse staffing efficiency. Health Manag Technol 2007;28:, 20–2. [PubMed]
192.
Junttila K, Meretoja R, Seppälä A, Tolppanen EM, Ala-Nikkola T, Silvennoinen L. Data warehouse approach to nursing management. J Nurs Manag 2007;15:155–61. 10.1111/j.1365-2834.2007.00690.x [PubMed] [CrossRef]
193.
Clark A, Moule P, Topping A, Serpell M. Rescheduling nursing shifts: scoping the challenge and examining the potential of mathematical model based tools. J Nurs Manag 2015;23:411–20. 10.1111/jonm.12158 [PubMed] [CrossRef]
194.
Wadsworth B, Kurilla ML. An automated solution for managing your workforce. Nurs Manage 2009;40:49–51. 10.1097/01.NUMA.0000356637.33834.00 [PubMed] [CrossRef]
195.
Wallace LA, Pierson S. A case study: the initiative to improve RN scheduling at Hamilton Health Sciences. Nurs Leadersh 2008;21:33–41. 10.12927/cjnl.2008.20285 [PubMed] [CrossRef]
196.
Baker RL, Tindell S, Buckley Behan D, Turpin PG, Rosenberger JM, Punnakitikashem P. Phase I: creating an electronic prototype to generate equitable hospital nurse-to-patient assignments. Comput Inform Nurs 2010;28:57–62. 10.1097/NCN.0b013e3181c0472c [PubMed] [CrossRef]
197.
Lammintakanen J, Saranto K, Kivinen T. Use of electronic information systems in nursing management. Int J Med Inform 2010;79:324–31. 10.1016/j.ijmedinf.2010.01.015 [PubMed] [CrossRef]
198.
Rapala KG. Staffing excellence: moving from retrospective to prospective management of risk. Nurs Econ 2011;29:211–14. [PubMed]
199.
Douglas K. What every nurse executive should know about staffing and scheduling technology initiatives. Nurs Econ 2011;29:273–5. [PubMed]
200.
Scott K, Van Norman J. Managing the complexity of a system wide electronic medical record design and implementation: lessons for nurse leaders. Nurs Adm Q 2009;33:109–15. 10.1097/NAQ.0b013e3181a10c64 [PubMed] [CrossRef]
201.
Silvestro R, Silvestro C. An evaluation of nurse rostering practices in the National Health Service. J Adv Nurs 2000;32:525–35. 10.1046/j.1365-2648.2000.01512.x [PubMed] [CrossRef]
202.
Kellagher M, Simpson J, Flynn B, Armstrong D. Workload and workforce planning: developing a learning toolkit. Nurs Manag 2010;17:32–4. 10.7748/nm2010.04.17.1.32.c7646 [PubMed] [CrossRef]
203.
Flynn B, Kellagher M, Simpson J. Workload and workforce planning: tools, education and training. Nurs Manag 2010;16:32–5. 10.7748/nm2010.03.16.10.32.c7612 [PubMed] [CrossRef]
204.
Szumlas S. Leveraging staff nurse engagement to design effective patient care assignments. Nurse Leader 2013;11:46–49. 10.1016/j.mnl.2012.12.001 [CrossRef]
205.
Burns JP. Complexity science and leadership in healthcare. J Nurs Adm 2001;31:474–82. 10.1097/00005110-200110000-00011 [PubMed] [CrossRef]
206.
Finn R. Does staff eRostering boost patient outcomes? Nurs Times 2013;109:20–1. [PubMed]
207.
Bostrom J, Suter WN. Charge nurse decision making about patient assignment. Nurs Adm Q 1992;16:32–8. 10.1097/00006216-199201640-00007 [CrossRef]
208.
Perroca MG, Ek AC. Utilization of patient classification systems in Swedish hospitals and the degree of satisfaction among nursing staff. J Nurs Manag 2007;15:472–80. 10.1111/j.1365-2834.2007.00732.x [PubMed] [CrossRef]
209.
Effken JA. Different lenses, improved outcomes: a new approach to the analysis and design of healthcare information systems. Int J Med Inform 2002;65:59–74. 10.1016/S1386-5056(02)00003-5 [PubMed] [CrossRef]
210.
Fagerström L, Rauhala A. Benchmarking in nursing care by the RAFAELA patient classification system – a possibility for nurse managers. J Nurs Manag 2007;15:683–92. 10.1111/j.1365-2934.2006.00728.x [PubMed] [CrossRef]
211.
Effken JA. Informational basis for expert intuition. J Adv Nurs 2001;34:246–55. 10.1046/j.1365-2648.2001.01751.x [PubMed] [CrossRef]
212.
Effken JA, Verran JA, Logue MD, Hsu YC. Nurse managers’ decisions: fast and favoring remediation. J Nurs Adm 2010;40:188–95. 10.1097/NNA.0b013e3181d40f7c [PMC free article] [PubMed] [CrossRef]
213.
Hogan H, Olsen S, Scobie S, Chapman E, Sachs R, Vincent C, et al. What can we learn about patient safety form information sources within an acute hospital: a step on the ladder of integrated risk management. Qual Saf Health Care 200;17:209–15. [PubMed]
214.
Vincent C, Burnett S, Carthey J. Safety measurement and monitoring in healthcare: a framework to guide clinical teams and healthcare organisations in maintaining safety. BMJ Qual Saf 2014;23:670–7. 10.1136/bmjqs-2013-002757 [PMC free article] [PubMed] [CrossRef]
215.
Rickles D, Hawe P, Shiell A. A simple guide to chaos and complexity. J Epidemiol Community Health 2007;61:933–7. 10.1136/jech.2006.054254 [PMC free article] [PubMed] [CrossRef]
216.
von Bertalanffy L. General System Theory: Foundations, Development, Applications. New York, NY: George Braziller; 1968.
217.
Zimmerman B, Lindberg C, Plsek P. Edgeware: Insights From Complexity Science for Health Care Leaders. Irving, TX: VHA, Inc.; 1998.
218.
Fielder F. Contingency model of leadership effectiveness. Adv Exp Soc Psychol 1964;1:149–90. 10.1016/S0065-2601(08)60051-9 [CrossRef]
219.
Latour B. Reassembling the Social: An Introduction to Actor-Network-Theory. Oxford: Oxford University Press; 2005.
220.
Perrow C. Normal Accidents, Living with High Risk Technologies. New York, NY: Basic Books; 1984.
221.
Bandura A. Social Learning Theory. New York, NY: General Learning Press; 1977.
222.
Weiner BJ. A theory of organizational readiness for change. Implement Sci 2009;4:67. 10.1186/1748-5908-4-67 [PMC free article] [PubMed] [CrossRef]
223.
Nonaka I, Von Krogh G. Perspective – tacit knowledge and knowledge conversion: controversy and advancement in organizational knowledge creation theory. Organ Sci 2009;20:635–52. 10.1287/orsc.1080.0412 [CrossRef]
224.
Argyris C, Schon DA. Organisational Learning. A Theory of Action Perspective. Reading, MA: Addison-Wesley; 1978.
225.
Bandura A. Self-efficacy mechanism in human agency. Am Psychol 1982;37:122–47. 10.1037/0003-066X.37.2.122 [CrossRef]
226.
Goleman D. Leadership that gets results. Harv Bus Rev March–April 2000; R00204.
227.
Bass BM. Leadership and Performance Beyond Expectations. New York, NY: Free Press; 1985.
228.
Avolio B, Luthans F, Walumbwa FO. Authentic Leadership: Theory-building for Veritable Sustained Performance. Working Paper. Lincoln, NE: Gallup Leadership Institute, University of Nebraska; 2004.
229.
Dreyfus H, Dreyfus S. Mind Over Machine. New York, NY: Free Press; 1982.
230.
Benner P. From Novice to Expert. Excellence and Power in Clinical Nursing Practice. Menlo Park, CA: Addison-Wesley; 1984.
231.
Bayes T. An essay towards solving a problem in the doctrine of chances. Phil Trans 1763;53:370–418.
232.
Laplace PS. Théorie Analytique des Probabilités. Paris: Courcier; 1812.
233.
Brunswick E. Organismic achievement and the environment probability. Psych Rev 1943;50:255–72. 10.1037/h0060889 [CrossRef]
234.
Hammond KR, Hamm RM, Grassia J, Pearson T. Direct comparison of the efficacy of intuitive and analytical cognition in expert judgement. IEEE Trans Cybern 1987;17:754–70.
235.
Simon H. Designing Organizations for an Information-Rich World. In Greenberger M, editor. Computers, Communication and the Public Interest. Stanford, CA: Stanford University Press; 1971. pp. 40–1.
236.
Ajzen I. The theory of planned behaviour. Organ Behav Hum Decis Process 1991;50:179–211. 10.1016/0749-5978(91)90020-T [CrossRef]
237.
Cyert R, March J. Behavioural Theory of the Firm. Oxford: Blackwell; 1963.
238.
Von Neumann J, Morgenstern O. Theory of Games and Economic Behaviour. Princeton, NJ: Princeton University Press; 1944.
239.
Jacko J, Stephanidis C. Human-Computer Interaction: Theory and Practice (Part 2), Volume 2. HCI International Conference Proceedings. Boca Raton, FL: CRC Press; 2003.
240.
Bijker WE, Hughes TP, Pinch T. The Social Construction of Technological Systems: New Directions in the Sociology and History of Technology. Cambridge, MA: Massachusetts Institute of Technology (MIT); 1987.
241.
Ackerman MS. The intellectual challenge of CSCW: the gap between social factors and technical feasibility. Hum Comput Interact 2000;15:179–203. 10.1207/S15327051HCI1523_5 [CrossRef]
242.
Curnock E, Ferguson J, McKay J, Bowie P. Healthcare Improvement and Rapid PDSA Cycles of Change: A Realist Synthesis of the Literature. Glasgow: Patient Safety Multi-Professional Steering Group of NHS Education for Scotland; 2012. URL: www​.nes.scot.nhs.uk/media​/1389875/pdsa_realist_synthesis.pdf (accessed October 2017).