The true costs of nursing care. A simple approach provides more accurate accounting of nursing services.

Since the prospective payment system mandated that they define and control costs more efficiently, healthcare organizations have separated nursing care from fixed overhead and reevaluated cost-containment restraints. Nursing objectives and daily data collection help to assign patients to one of four classes, from routine to continuous care. Providers can use these four classifications to monitor nursing productivity and allocate labor, employing such set variables as hours per patient day, indirect care, constant time, productive and nonproductive time, and profit margin. The result of this system is variable billing that more accurately reflects the true cost of nursing care. This proposed system of more open cost accounting makes patients and families more knowledgeable consumers. Administrators reviewing such cost breakdowns can evaluate nursing and other departments more effectively and market specific services more competitively. The system shows that nursing can be a profit, not a cost, center, which increases nurses' commitment and satisfaction. Organizations should encourage nurse managers to incorporate business into their traditional role. Cost accounting within nursing makes identified costs more manageable and increases efficiency throughout the organization.