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WISN


BAHAGIAN PERUBATAN
JKN PERAK
INTRODUCTION
• Objective of workforce planning :
To place
• Right people
• In the right place
• At the right time
• With the right skills and education
• Of the right skills mix
HUMAN RESOURCE MANAGEMENT
• Plan the number and type of HRH it requires
• Allocate HRH to different health units
• Methods :
a) Old method : - Population ratio
                  - Fixes staff schedule
b) New method : - WISN
• Weakness of old method : Ignore local
   differences in the amount and type of work
   that health workers do
WISN
• New method based on the actual work that
  health workers do (workload).
• Can be applied to - medical staff
                      - paramedic
                      - non-clinical staffs
• Useful : - calculating both current and future
             HRH requirements.
           - comparing level of HRH in different
             areas or health facilities.
           - Indicates how much work pressure
             HRH are under
STEPS IN WISN METHODOLOGY
1. Set WISN target
2. Estimate Available Working Time (AWT)
3. Define components of work
4. Set activity standards (service standards &
   allowance standards)
5. Calculate standard workloads
6. Calculate allowance factors
7. Calculate required staff requirement
1. Set WISN target
• Select staff category
• Type of facility (hospital, KK, Unit)
• Geographic areas (remote KK vs urban KKs)
2. Estimate Available Working Time(AWT)

No Item                             Days              eg
1      Working day / week           A                 5
2.     Working days/year            B (Ax 52)          260 (5x 52 )
3      Annual leave                 C                  30
4      Public holidays              D                 18
5      Sick leave                   E                 7
6      Special leave                F                 0
7      Working hrs/day              G                 8

                                           Contoh :
    AWT = B- (C+D+E+F) days /year          260-(30+18+7+0) =205
        =H
CONVERTING AWT TO OTHER UNITS
• Days / year = H x 8 hrs = hrs/year
              = H x 8 x 60 = min/year

Contoh 205 working days /year
       = 205 x8 =1640 hrs/year
       = 205 x8x60 = 98400min/year
3. Define work components
Workload group                            Workload component
Health service activities of all cadre
groups




Support activities of all cadre groups




Additional activities of certain cadres
members
4. Set Activity Standard
• Definition:
   The time it takes a trained and well-motivated
  member of a particular staff category to perform
  the action to acceptable professional standards
  in the circumstances of the country.
• Two types of Activity Standards
   - Service Standards
   - Allowance Standards
• Shown as unit time
Activity Standard
Health service activity        Unit time
Service standards




Category allowance factors



Individual allowance factors
Service Standards
Health service activity   Unit Time
Outpatient consultation   min/patient
Procedure                 min/patient
Ward round                min / patient
Grand ward round          hrs/session
CATEGORY ALLOWANCE STANDARD
• For activities that are not reported in annual service
  statistics
   Activity                 Unit time       Proportion of AWT
   QA activity              2 Hrs/ week     Eg 2hrs/wk = 2/8x5 =
                                            0.05
   CME                      1 Hr/week       Eg 1 hr/wk = 1/40=0.025
   Training (LDP)           7 days /year    Eg 7/205 = 0.034
   Meeting                  2 Hrs / month   Eg 2x12/1640= 0.014
   Reporting                4 Hrs/week      Eg 4 /40 = 0.1
                 Total CAF/100              0.05+0.025+0.034+0.1=
                                            0.209
   Allowance multiplier =                   __1___     = 1.264
                                            1- 0.209
INDIVIDUAL ALLOWANCE FACTORS
• For activities that are not reported in annual
  service statistics done by selected staffs

 Activity         No of      Unit time   Proportion of AWT
                  staffs
                  involved
 Doing returns        1        4 hrs /   4/ (4x40)= 0.025
                               month
 Stock checking       2        2 hrs /   2 x 2/(4x40) = 0.025
                               month
 Supervision of       1        4 hrs /   4x12/1640 = 0.029
 students                      month
Standard Workloads
• Definition :
  Amount of work (within one activity) that one person
 could do in a year.

• If expressed as unit time for the activity:
  Std. workload = Available working time in a year
                   Unit time for the activity

• If expressed as rate of working:
  Std. workload = Rate x Available working time in a year
Standard Workloads
                   Staff category : Medical officer
            AWT in a year = 205 days/ 1640 hrs /98400 min
Health service            Unit time or rate of   Standard workload
activity                  working
Outpatient consultation    10 min/patient        98400/10= 9840
                                                           pts/year
Procedure                 2 hrs/day              8/2 x 205 = 820
                                                             proc/yr
 Ward rounds              15 min /patient        98400/15 = 6560
                                                            pts/yr
Grand ward round          1 session/week         52 x1 = 52 grand ward
                                                         round /year
DETERMINING STAFF REQUIREMENTS
• Total staff requirements = (staff required for
  service activity X staff requirement (CAF) +
  Staff requirement (IAF)
SAMPLE CALCULATION : MO IN SPECIALIST HOSPITAL
MEDICAL DEPT
WORKLOAD CATEGORY              WORKLOAD COMPONENT
Service activities             • Outpatient consultation
                               • Ward rounds
                               • Procedures
                               • Grand ward rounds
Category allowance factors     • QA activities
                               • CME
                               • LDP
                               • Meeting
                               • Reporting
Individual allowance factors   • Supervision of students
STAFF REQUIREMENT FOR SERVICE ACTIVITY
                 (A)
                          Staff category : Medical officer
                   AWT in a year = 205 days/ 1640 hrs /98400 min

Health service      Unit time or        Standard            Annual work load      Staff requirement
activity            rate of working     workload
Outpatient           10 min/patient     98400/10= 9840      10,000 out pt         10,000/9840=
consultation                            pts/year                                  1.016

Procedure           2 hrs/day           8/2 x 205 = 820     1000 hrs              1000/820 =1.220
                                        hrs /yr
 Ward rounds        15 min /patient     98400/15 = 6560     6000 inpts            6000/6560=
                                        pts/yr                                    0.915

Grand ward round    1 session/week      52 x1 = 52 grand    46 grand ward         46/52 = 0.885
                                        ward round /year    rounds
Staff requirement based on service activities = 1.016+0.915+1.220+0.885 = 4.036
STAFF REQUIREMENT FOR CAF
            (B)
STAFF REQUIREMENT BASED ON IAF
                           (C)

Activity         No of staffs   Unit time        Proportion of
                 involved                        AWT
Supervision of           1       4 hrs / month   4x12/1640 =
students                                         0.029
TOTAL STAFF REQUIREMENT BASED ON WISN

• Total staff requirement = (AXB) +C
                          = (4.036x1.264) +0.029
                          = 5.130
ANALYSIS & INTEPRETING WISN
• WISN difference : difference between current
  and required staffing levels
   -ve : shortage
   +ve : surplus

• WISN ratio : current staff/ required staff
 < 1.0 : high work pressure
 > 1.0 : low work pressure
EXAMPLE OF ANALYSIS
STAFF CATEGORY : MEDICAL OFFICERS IN DISTRICT HOSPITALS
                       OF PERAK
DH    Current    Required     WISN       Workforce   WISN    Workload
     number of   number     difference   problem     ratio   pressure
       MO        (WISN)
 A       8          7          +1         Surplus    1.14     None
 B       6          8          -2        Shortage    0.75     High
 C      10          7          +3         Surplus    1.43     None
 D      11          11          0         Balance     1.0    Normal

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Wisn prog perubatan teaching module

  • 2. INTRODUCTION • Objective of workforce planning : To place • Right people • In the right place • At the right time • With the right skills and education • Of the right skills mix
  • 3. HUMAN RESOURCE MANAGEMENT • Plan the number and type of HRH it requires • Allocate HRH to different health units • Methods : a) Old method : - Population ratio - Fixes staff schedule b) New method : - WISN • Weakness of old method : Ignore local differences in the amount and type of work that health workers do
  • 4. WISN • New method based on the actual work that health workers do (workload). • Can be applied to - medical staff - paramedic - non-clinical staffs • Useful : - calculating both current and future HRH requirements. - comparing level of HRH in different areas or health facilities. - Indicates how much work pressure HRH are under
  • 5.
  • 6. STEPS IN WISN METHODOLOGY 1. Set WISN target 2. Estimate Available Working Time (AWT) 3. Define components of work 4. Set activity standards (service standards & allowance standards) 5. Calculate standard workloads 6. Calculate allowance factors 7. Calculate required staff requirement
  • 7. 1. Set WISN target • Select staff category • Type of facility (hospital, KK, Unit) • Geographic areas (remote KK vs urban KKs)
  • 8. 2. Estimate Available Working Time(AWT) No Item Days eg 1 Working day / week A 5 2. Working days/year B (Ax 52) 260 (5x 52 ) 3 Annual leave C 30 4 Public holidays D 18 5 Sick leave E 7 6 Special leave F 0 7 Working hrs/day G 8 Contoh : AWT = B- (C+D+E+F) days /year 260-(30+18+7+0) =205 =H
  • 9. CONVERTING AWT TO OTHER UNITS • Days / year = H x 8 hrs = hrs/year = H x 8 x 60 = min/year Contoh 205 working days /year = 205 x8 =1640 hrs/year = 205 x8x60 = 98400min/year
  • 10. 3. Define work components Workload group Workload component Health service activities of all cadre groups Support activities of all cadre groups Additional activities of certain cadres members
  • 11. 4. Set Activity Standard • Definition: The time it takes a trained and well-motivated member of a particular staff category to perform the action to acceptable professional standards in the circumstances of the country. • Two types of Activity Standards - Service Standards - Allowance Standards • Shown as unit time
  • 12. Activity Standard Health service activity Unit time Service standards Category allowance factors Individual allowance factors
  • 13. Service Standards Health service activity Unit Time Outpatient consultation min/patient Procedure min/patient Ward round min / patient Grand ward round hrs/session
  • 14. CATEGORY ALLOWANCE STANDARD • For activities that are not reported in annual service statistics Activity Unit time Proportion of AWT QA activity 2 Hrs/ week Eg 2hrs/wk = 2/8x5 = 0.05 CME 1 Hr/week Eg 1 hr/wk = 1/40=0.025 Training (LDP) 7 days /year Eg 7/205 = 0.034 Meeting 2 Hrs / month Eg 2x12/1640= 0.014 Reporting 4 Hrs/week Eg 4 /40 = 0.1 Total CAF/100 0.05+0.025+0.034+0.1= 0.209 Allowance multiplier = __1___ = 1.264 1- 0.209
  • 15. INDIVIDUAL ALLOWANCE FACTORS • For activities that are not reported in annual service statistics done by selected staffs Activity No of Unit time Proportion of AWT staffs involved Doing returns 1 4 hrs / 4/ (4x40)= 0.025 month Stock checking 2 2 hrs / 2 x 2/(4x40) = 0.025 month Supervision of 1 4 hrs / 4x12/1640 = 0.029 students month
  • 16. Standard Workloads • Definition : Amount of work (within one activity) that one person could do in a year. • If expressed as unit time for the activity: Std. workload = Available working time in a year Unit time for the activity • If expressed as rate of working: Std. workload = Rate x Available working time in a year
  • 17. Standard Workloads Staff category : Medical officer AWT in a year = 205 days/ 1640 hrs /98400 min Health service Unit time or rate of Standard workload activity working Outpatient consultation 10 min/patient 98400/10= 9840 pts/year Procedure 2 hrs/day 8/2 x 205 = 820 proc/yr Ward rounds 15 min /patient 98400/15 = 6560 pts/yr Grand ward round 1 session/week 52 x1 = 52 grand ward round /year
  • 18. DETERMINING STAFF REQUIREMENTS • Total staff requirements = (staff required for service activity X staff requirement (CAF) + Staff requirement (IAF)
  • 19. SAMPLE CALCULATION : MO IN SPECIALIST HOSPITAL MEDICAL DEPT WORKLOAD CATEGORY WORKLOAD COMPONENT Service activities • Outpatient consultation • Ward rounds • Procedures • Grand ward rounds Category allowance factors • QA activities • CME • LDP • Meeting • Reporting Individual allowance factors • Supervision of students
  • 20. STAFF REQUIREMENT FOR SERVICE ACTIVITY (A) Staff category : Medical officer AWT in a year = 205 days/ 1640 hrs /98400 min Health service Unit time or Standard Annual work load Staff requirement activity rate of working workload Outpatient 10 min/patient 98400/10= 9840 10,000 out pt 10,000/9840= consultation pts/year 1.016 Procedure 2 hrs/day 8/2 x 205 = 820 1000 hrs 1000/820 =1.220 hrs /yr Ward rounds 15 min /patient 98400/15 = 6560 6000 inpts 6000/6560= pts/yr 0.915 Grand ward round 1 session/week 52 x1 = 52 grand 46 grand ward 46/52 = 0.885 ward round /year rounds Staff requirement based on service activities = 1.016+0.915+1.220+0.885 = 4.036
  • 22. STAFF REQUIREMENT BASED ON IAF (C) Activity No of staffs Unit time Proportion of involved AWT Supervision of 1 4 hrs / month 4x12/1640 = students 0.029
  • 23. TOTAL STAFF REQUIREMENT BASED ON WISN • Total staff requirement = (AXB) +C = (4.036x1.264) +0.029 = 5.130
  • 24. ANALYSIS & INTEPRETING WISN • WISN difference : difference between current and required staffing levels -ve : shortage +ve : surplus • WISN ratio : current staff/ required staff < 1.0 : high work pressure > 1.0 : low work pressure
  • 25. EXAMPLE OF ANALYSIS STAFF CATEGORY : MEDICAL OFFICERS IN DISTRICT HOSPITALS OF PERAK DH Current Required WISN Workforce WISN Workload number of number difference problem ratio pressure MO (WISN) A 8 7 +1 Surplus 1.14 None B 6 8 -2 Shortage 0.75 High C 10 7 +3 Surplus 1.43 None D 11 11 0 Balance 1.0 Normal