About BESTThis tool has been developed by the RCN Emergency Care Association (ECA) and Faculty of Emergency Nursing (FEN).
BEST is a workforce planning tool for use at local level in your Emergency Department (ED) to allow any disparity between nursing workload and staffing to be highlighted. The tool allows you to:
- analyse the volume and pattern of nursing workload in your ED
- track this against your rostered staffing level
- calculate the whole time equivalent workforce and skill mix which would be required to provide the nursing care needed in the department during the audit period.
What's requiredThe BEST calculation requires data to be collected and input for a seven-day period on an hour-by-hour basis. A user guide is provided below, together with the various data collection appendices to explain how to gather your data, how to enter it and what the results portray.
It is important to pay particular attention to the definitions and instructions relating to:
- how to measure patients dependency in adults and children
- which staff to include and which to exclude.
How it worksThe calculations work by using nurse-to-patient ratios in the various dependency categories.
The ratios used by BEST are:
- total dependency - 2 nurses to 1 patient
- high dependency – 1 nurse to 1 patient
- moderate dependency - 1 nurse to 2 patients
- low dependency - 1 nurse to 3.5 patients
The hourly data sets used by BEST are:
- patient dependency volume in the department using the Jones Dependency Tool
- the total number of staff rostered to be clinical on shift in the department.
For help and advice or to offer feedback please email us at email@example.com.
How to use BEST (PDF 298 KB)
Appendix A - Adult JDT (PDF 27 KB)
Appendix B - Nursing workload sheet for confirming patient category (PDF 28 KB)
Appendix C - Children’s JDT (PDF 29 KB)
Appendix D - Hourly data collection tool (PDF 82 KB)
Appendix E - Cumulative hourly totals (PDF 93 KB)