A COMPUTER-BASED MODEL FOR ANALYZING STAFFING NEEDS OF PSYCHIATRIC-TREATMENT PROGRAMS

The author describes a computer-based model that derives nonnursing st affing requirements from quantifiable performance expectations for str uctured psychotherapy and rehabilitation therapy. Input variables incl ude treatment mode, contact hours, patient volume (average daily censu s and average length of stay), hours of structured therapy per week, a ssessment and discharge activities, and ancillary staff activities. Ou tput variables are number of staff needed weekly productivity ratios s uch as hours of direct service per full-time-equivalent position and n ew patients served per full-time-equivalent position, and hours of str uctured therapy per day per patient. Initial validation of the model c ompared its predictions of staffing requirements with predictions base d on staffing ratios derived from the literature and with actual staff ing levels at the author's institution. The model was used in an analy sis of two hypothetical scenarios showing the effects of managed care on variables that influence staffing. The results showed that as avera ge length of stay decreases under managed care, reimbursement based on number of patients served at one time decreases, although costs of pr oviding treatment increase because the program needs more staff to han dle the increased number of admissions and discharges.