Abstract
This article examines one hospital's journey to improve the way in which the nursing workforce was used. A clear message in Lord Carter's review for the Department of Health ( Carter, 2016 ) was to drive efficiency and work towards being the 'model hospital'. With the introduction of the care hours per patient day, a new rota management system, and a review of the establishment tool used, the hospital has developed a way of real time tracking of nursing time against patient care needs on a ward-by-ward basis. The trust also used a newly developed establishment tool to triangulate and articulate particular patient care requirements.
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