Manpower utilization study, San Carlos Hospital.

The San Carlos Service Unit provides direct in-patient and out-patient field health services. It is responsible for the health care of some 5,800 San Carlos Indians on the Reservation and in the surrounding urban areas. This manpower utilization study is an integral part of the federal government's continuing efforts to measure its efficiency as well as its effectiveness. This study supported the development of productivity indices, work measurement, and unit-cost analysis and performance. The San Carlos Study was developed as a prototype to help to bring all DHEW under a manpower utilization system within four years. In the work measurement system, the Indian Health Service (IHS) was concerned with measuring the manpower requirements at the San Carlos Service Unit, in order to provide a possible model for manpower allocation. In the modifications of prototype procedures, IHS modified six areas. Specifically, modified procedures were set up in the following areas: 1) actual hours worked; 2) patient counts; 3) average lengths of stay and average visits per patient; 4) staff criteria; 5) standard dues; and 6) manpower requirements. This measurement system made it possible for IHS to provide both a quantity and quality measurement of services. The results showed a staffing deficiency of 27 percent for hospital health in 1973. Medicine showed an apparent adequate staff, while nursing had only a 13 percent deficiency. Note that physicians provided services as needed and often worked over a 40-hour week. It was also discovered that support services provided for the greatest staff deficiencies at a 30 percent deficiency rate. The study further indicated that facility maintenance, mental health, and pharmacy were in need of additional staff in FY 1973. Specific recommendations are not provided.