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Aiken, L., Sloane, D.S., Bruyneel, L., Van den Heede, K., Griffiths, P., Busse, R., Diomidous, M., Kinnunen, J., Kózka, M., Lesaffre, E., McHugh, M.D., Moreno-Casbas, M.T., Rafferty, A.M., Schwendimann, R., Scott, A.P., Tishelman, C., Theo van Achterberg, T. and Sermeus, W. (2014) Nurse Staffing and Education and Hospital Morality in Nine European Countries: A Retrospective Observational Study. The Lancet, 383, 1824-1830.
http://dx.doi.org/10.1016/S0140-6736(13)62631-8

has been cited by the following article:

• TITLE: A Qualitative Study of Manager Experiences Using the RAFAELA System

  AUTHORS: Nina Berger Hustad, Ragnhild Hellesø, Marit Helen Andersen

  KEYWORDS: the RAFAELA System, Patients’ Care Needs, Nurse Staffing, Manager Experiences, In-Depth Interviews

  JOURNAL NAME: Open Journal of Nursing, Vol.5 No.11, November 23, 2015

  ABSTRACT: Objective: The objective was to explore manager experiences using the RAFAELA system. Background: The RAFAELA system was developed in Finland during the 1990s to create a work situation where patients’ care needs were balanced with personnel resources. The system is used in almost all hospitals in Finland and is implemented in several European countries. However, the system has never been evaluated outside Finland. This study, focusing on the managers’ perspective, represents the second report from a larger Norwegian evaluation project of the RAFAELA system. Methods: An explorative qualitative design was chosen. Data were collected by individual in-depth interviews at a university hospital in Norway during 2012-2013. A total of 10 informants in various management positions were interviewed. The tape-recorded interviews were transcribed verbatim, and the transcripts were analysed using Kvale’s method for content analysis. Results: Four main themes emerged from the qualitative data: making the invisible visible; a common language; a system for prospective planning; and a resource-demanding tool. Conclusions: The study indicated that the RAFAELA system provided useful information about the patients’ care needs and nursing activities. Also the system provided a common reference frame for discussing nursing, staffing and allocation. Although the managers considered the RAFAELA to be time consuming in the implementation phase, they considered the system to be an important tool.