Nurse executives' use of a labor computer decision support system: Differences in nursing labor cost per patient day

To control nursing labor cost, nurse executives need access to productivity and financial performance information on a daily basis. Labor cost and variance reports after the fact are no longer acceptable for making crucial management labor decisions.;The purpose of this study was to determine whether there was a meaningful difference in nursing labor cost per patient day (PPD) when a nurse executive used a labor computer decision support system (CDSS) compared with nurse executives who did not use the system. The CDSS provided the nurse executives with daily labor cost information on which to base labor decisions. The conceptual framework of the study was based on Simon's (1977) decision making theory and Turban's (1982) conceptual model of a computer decision support system.;This descriptive study was implemented on a study and comparison unit in a psychiatric and a medical hospital. The labor CDSS was installed on the nurse executives' personal computers in the study unit and the comparison nurse executives used their usual manual system. These study group nurse executives entered census and hours worked data in the categories of registered nurse, licensed practical nurse, and nursing assistant every 1 to 3 days for a 3-month study period. The CDSS converted these entered data to information on critical indicators (e.g., cost PPD) which the nurse executives used to make decisions regarding nursing labor costs.;A mean cost PPD from a 3-month baseline period was compared with a mean cost PPD from the 3-month study period. The data suggested that CDSS use did make a meaningful difference on the two study units' costs PPD compared with the two comparison units, costs PPD. The CDSS nurse executive in the psychiatric hospital decreased labor cost under budget by 53%, whereas the comparison nurse executive increased cost over budget by 61%. The medical CDSS nurse executive increased cost over budget during the study period by 367%, but the comparison nurse executive increased cost over budget by 514%.