Feeling the Stress of Staffing? Have you Checked your Labor per Patient/Resident Day Trends?

By Christin Swingle posted 04-28-2023 13:00


Feeling the Stress of Staffing? Have you Checked your Labor per Patient/Resident Day Trends?

Labor per patient, or resident, day is a metric used in many healthcare and senior living foodservice operations to evaluate an operation’s workforce as it relates to patient and resident volumes. It is determined using productive hours, clinical productive hours, and total patient days. Total patient days are typically available through the finance department and include total inpatient days from the day of admission, but not the day of discharge. Newborn patient days are also excluded from this measure. Productive hours will include all foodservice worked hours for the month, but not clinical hours. Clinical hours will be the total dietitian and dietitian technician’s worked hours for the month.


During times of high patient/resident volumes, when staffing is short, an operation will see a dip in this metric. This often coincides with decreased quality, safety, and overall patient satisfaction. This metric can be useful for assessing and justifying increased labor needs, or for evaluating operations during staffing shortages. For example, when your labor per patient, or resident, days hit a certain threshold, the operation may have a protocol in place where non-essential tasks, such as catering, are put on hold to focus on patient/resident services. Comparing labor to patient days is widely used in the healthcare settings which often simplifies communication with leadership.

Case Study Example

Jenny has been the Food and Nutrition Director at South Memorial Hospital, a 450-bed acute care facility, for roughly fifteen years. Over the past year she experienced more staffing challenges related to recruitment, acute illnesses, and extended leaves than ever before.

A meeting was called with her supervisor and the patient experience department. Patient satisfaction scores were trending down overall, and there was an increase in negative comments regarding her team’s room service program. Historically, her operation scored very well! There were also three incidents where staff delivered trays to the wrong patients, and two employee injuries in just the last month!

Prior to the meeting, Jenny did her research, talked to her team, and crunched some numbers… she feels strongly that her crew is simply spread too thin. She plans to request permission to modify operations as soon as possible to ensure patient services are safe. 

Jenny takes the time to outline her assessment verbally but is also prepared with the trends below to paint the picture. She averaged the labor per patient day during the facility’s “busier” 6-month season dating back to 2020 and compared it to the number of negative patient comments/complaints and number of patient & employee safety incidents:

Labor per Patient Day Chart

Jenny was very nervous going into this meeting, but she was able to explain the hardship poor staffing is having on their operation and patient experience. Jenny and the leadership team developed a plan to pause and assess operations when labor per patient day dipped below 0.135 going forward. Additionally, leadership requested that HR develop a foodservice personnel recruitment campaign. Finance assessed the increased usage of medical leave and approved an extra FTE to cover these non-productive hours, and it was unanimously approved that in-house catering would be paused until the labor per patient day was above 0.130. 
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Article by AHF Benchmarking Committee Member Johannah Schrader, RD, LD, CDCES, North Kansas City Hospital