FAQ

Methodology FAQs

Overview

Implementation

Measurement/Analysis

Monitoring

Data Analysis

About GRASP

Q. Is GRASP just for nursing?
A. No. GRASP is not just for nursing. In fact, the system has been used in almost every department or area in healthcare facilities. These include pharmacy, all the therapies, social work, laboratory, radiology, housekeeping, dietary (nutritional services), and chaplain services, to name just a few.

Q. What's unique about The GRASP System?
A. Its flexibility. It's also simple and easy to use by both staff and managers. Through continued feedback from our customers, we continue to work with our clients to enhance our products to better suit their unique facility workload requirements.

Q. How is the GRASP data collected?
A. GRASP Systems employs an automated, PC-based method to collect data. Data can also be collected through a facility's automated documentation system. Of course, data can also be collected manually, though this is not recommended.

Q. How is the GRASP System implemented?
A. GRASP consultants are all former nurses and professional healthcare staff members who understand your challenges. As the implementation project progresses, your consultant guides you and your staff through each stage using templates and definitions to streamline the process - using a detailed project plan.

Back to top

Implementation

Q. I've just signed a contract for GRASP . How do I start collecting information for indirect care? Should I get that started before the consultant arrives?
A. There is no need to start this process yet. GRASP Systems will provide you tools to help with this process, including a comprehensive prompter list. Your consultant will review this process with you during the implementation phase.

Q. Can I use my documentation system to collect GRASP data?
A. This is a qualified yes. It depends on the documentation system you currently employ and your current goals. It is key that the documentation system must be capable of embedding a numeric value behind each intervention and that those values be added together. Some systems place prospective data in the Care Planning, Acuity or Order Set areas. If you collect data in the actual documentation, your values will be retrospective since staff documentation occurs after the fact. Your GRASP consultant can offer specific recommendations for your individual system.

Q. We just changed to a new care delivery model. It's a non-traditional way of delivering care. Will GRASP work for us?
A. GRASP works regardless of the care delivery model and setting. GRASP works for clinical and non-clinical departments, as well.

Back to top

Measurement/Analysis

Q. Do we have to do time studies? I've heard Work Sampling is the only method for a truly valid system.
A. Time studies are not required because GRASP Systems has an extensive normal time and frequency database updated annually. Many facilities successfully use GRASP without time studies; they start with our model instruments, then test and modify them using a consensus approach. GRASP recognizes that Work Sampling is considered the gold standard; while we can accommodate it, we don't recommend it because it is unnecessarily cost prohibitive and tedious.

Q. If different units have different instruments, how can I ever compare them?
A. Different units generally have different patient populations. Typically the type of care varies between units. The key is to translate the patient requirements into a comparable measure - that measure is time. GRASP translates patient requirements into hours of care. There is simply no better way to make these comparisons. Of course if practice is the same throughout your facility, then many of the interventions will be the same between units/wards.

Q. The other systems I've seen are all level systems. Why doesn't GRASP use levels?
A. Level systems rely on an even distribution within levels so that all patients aren't one extreme or the other within any given level. Levels have ranges of time. If patients in any given level skew exclusively toward the high or low end, it can easily result in under- or over-staffing. We refer to this as "Acuity Creep" . GRASP eliminates this issue. Staffing is based on the hours of care that are required by each individual patient, not an aggregate level. GRASP data can be customized into levels although it's rarely necessary once the hours of care approach is engaged.

Q. Must I use GRASP on every patient every day?
A. GRASP's flexibility makes it easy to choose the assessment that best fits your needs. You can assess your patients as often as you feel necessary if you're not trying to meet a governmental mandate that requires daily assessment. If you're staffing based on daily changes in your patients, you may wish to assess your patients once a day and/or as their status changes. If you're using GRASP data strictly to establish a matrix and for budgetary purposes, assessing patients once a quarter may be sufficient.

Q. Are GRASP instruments prospective or retrospective?
A. They can be either, except in obvious cases, such as Emergency Department and Obstetrics, where prospective is impossible. We offer the only solution to allow you both options. Whether an instrument is prospective or retrospective will be a philosophical decision you'll make based on how the information will be used within your organization. When you make that decision, keep in mind your governmental requirements and your organization's future directions.

Q. Are GRASP instruments always 24-hour instruments?
A. No. They can be designed to reflect the work over the time period you choose. You could choose an eight-hour shift, a 12-hour shift, a different shift length, or an entire day. The choice is yours based on the goal you have defined for the data.

Q. Can GRASP Systems give facilities average HPPD's for surgical patients, outpatients, medical patients, etc.?
A. Yes. Facilities can obtain this information several ways. If your facility is part of GRASP Systems National Comparative Databases (NCD), you'll receive this information as part of your quarterly reports. If your facility has a GRASP Systems Annual Maintenance Contract and is not part of the NCD, this information can be provided to you on a one-time basis when some unit/ward specific information is provided. If your facility is not part of GRASP Systems, we can provide this information by unit/ward for a fee per unit with your facility providing unit specific information.

Back to top

Monitoring

Q. How often do I need to review my instrument?
A. This is usually determined by regulatory requirements for updating workload instruments. Our research has found that changes in the healthcare system make it wise to update once every 12 to 18 months and more often if you change your practices, procedures, or policies.

Q. How often should reliability monitoring be performed?
A. This varies by unit type, but may often be 10 percent of your average daily census per week. Your GRASP consultant will help you identify the best schedule, which will meet your regulatory requirements, your organizational needs and provide data credibility.

Q. How often should we perform our "Percent of Care Delivered" audits?
A. We recommend that you perform "Percent of Care Delivered" audits at 10 percent of your average daily census per month.

Q. How often should we conduct a skill mix review?
A. Skill mix reviews should be conducted when there is an identified need for making changes in the skill mix. Some facilities conduct skill mix studies annually. How often you conduct a skill mix review depends on your organization's individual needs.

Back to top

Data Analysis

Q. How do I use my data for program management?
A. Regardless of your organizational design, GRASP data can be bundled appropriately to meet your needs. Your GRASP consultant will assist you in identifying the best setup for collecting workload information based on your facility's management methods.

Q. What do the reports mean and which are the important ones to review?
A. During the implementation process, your reports will be reviewed and your consultant will show you how to interpret the data. If your facility has a maintenance agreement, reports may be reviewed again with your consultant during a scheduled on-site visit. Reports which are usually reviewed on a daily, monthly, or quarterly basis can be discussed during this educational session. If your facility has no maintenance agreement, contact us for contract or hourly rate prices.

Q. I need to prove how a change in practice will be cost effective before I start. How can I accomplish this?
A. Your facility's consultant can show you how to cost the current practice, identify workload-related activities with the new practice, and cost the change in practice. You can then annualize these costs to identify potential savings. In addition, outcomes anticipated by your facility can also be identified and costs of changes noted.

Q. How do I work out my staffing needs using HPPD's?
A. To determine staffing by HPPD's, multiply the average HPPD's by the average daily census. Multiply this number by 365 to identify the annual workload requirement. Divide this requirement by the Full Time Equivalent/Whole Time Equivalent ratio to obtain the result in FTE/WTE's.

Q. Once the FTE/WTE's are determined, how is this converted to skill mix requirements?
A. If a skill mix analysis was not included in your initial contract, then your facility can request an estimate for an add-on contract; the contract is based on your facility's budget. This add-on contract provides the training and on-site assistance needed by staff to conduct a skill mix analysis. Additionally, GRASP Systems can conduct the study at your facility's request.

Q. The number of beds will be increasing on one of our units. How much staff will we need to cover the increase?
A. GRASP clients have access to the National Comparative Databases for various patient populations and services. This information can provide you with hard data to assist with staffing resource requirements.

Q. How do I link workload data with other outcomes measures that I've implemented in my organization?
A. You can do this manually or automated. If you collect the outcome data for both patient and staff manually, you can collect and enter it manually in the quality evaluation section. You can then compare utilization percentages and HPPD's with the numbers of patient and/or staff outcomes. If you collect the quality data in an automated environment, GRASP Systems will assist with an interface between GRASP and the program you use.

Back to top