A Workload Indicators of Staffing Need (WISN) based framework and implementation tool for dietitians at South African central and tertiary public hospitals

Abstract Background Quality nutrition services are dependent upon the accessibility and availability of nutrition professionals. In this study, we used the World Health Organization’s Workload Indicators of Staffing Need (WISN) methodology to develop a dietetic staffing norm framework and implementa...

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Main Authors: Vertharani Nolene Naicker, Jane W. Muchiri, Keshan Naidoo, Modiehi Heather Legodi
Format: Article
Language:English
Published: BMC 2025-01-01
Series:BMC Health Services Research
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Online Access:https://doi.org/10.1186/s12913-025-12286-8
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author Vertharani Nolene Naicker
Jane W. Muchiri
Keshan Naidoo
Modiehi Heather Legodi
author_facet Vertharani Nolene Naicker
Jane W. Muchiri
Keshan Naidoo
Modiehi Heather Legodi
author_sort Vertharani Nolene Naicker
collection DOAJ
description Abstract Background Quality nutrition services are dependent upon the accessibility and availability of nutrition professionals. In this study, we used the World Health Organization’s Workload Indicators of Staffing Need (WISN) methodology to develop a dietetic staffing norm framework and implementation tool for South African central and tertiary public hospitals. Methods We followed the eight step WISN methodology as a basis for this developmental study. National data on permanently employed dietitians in public hospitals were used to determine the facility type. Available working time (AWT) was determined using WISN calculations and SA labour regulations. Consensus on workload components (WC) and activity standards (AS) was achieved through a Delphi exercise. Steps 5 to 8 ended in determination of dietitian requirements based on WISN software. Similar steps were used to develop the framework and tool. The tool’s calculated outputs were compared against the WISN software. Results Central and tertiary public hospitals were identified as the target facilities. Dietitians AWT at these facilities was calculated as 1528 h per year. A final list of 45 WC and aligned AS was obtained and provided the necessary contextualization. A WISN based framework, and a Microsoft Excel tool (calculator) resulted. Calculated average dietitians’ requirements were 24.59 and 24.23 for WISN software and the excel tool respectively. Conclusion The WISN methodology is a versatile tool that allows for the development of context and cadre specific staffing norm implementation frameworks and tools. The developed tool is valid and contextualized to determine the specific need for dietitians at SA central and tertiary public hospitals. These results will help policy makers to plan and forecast dietetic staffing needs at a macro level.
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spelling doaj-art-54354c11a4ff4d578f623a234f17d1552025-01-26T12:22:11ZengBMCBMC Health Services Research1472-69632025-01-0125111210.1186/s12913-025-12286-8A Workload Indicators of Staffing Need (WISN) based framework and implementation tool for dietitians at South African central and tertiary public hospitalsVertharani Nolene Naicker0Jane W. Muchiri1Keshan Naidoo2Modiehi Heather Legodi3National Department of HealthDepartment of Human Nutrition, Faculty of Health Sciences, University of PretoriaRight to CareDepartment of Human Nutrition and Dietetics, School of Health Care Sciences, Sefako Makgatho Health Sciences UniversityAbstract Background Quality nutrition services are dependent upon the accessibility and availability of nutrition professionals. In this study, we used the World Health Organization’s Workload Indicators of Staffing Need (WISN) methodology to develop a dietetic staffing norm framework and implementation tool for South African central and tertiary public hospitals. Methods We followed the eight step WISN methodology as a basis for this developmental study. National data on permanently employed dietitians in public hospitals were used to determine the facility type. Available working time (AWT) was determined using WISN calculations and SA labour regulations. Consensus on workload components (WC) and activity standards (AS) was achieved through a Delphi exercise. Steps 5 to 8 ended in determination of dietitian requirements based on WISN software. Similar steps were used to develop the framework and tool. The tool’s calculated outputs were compared against the WISN software. Results Central and tertiary public hospitals were identified as the target facilities. Dietitians AWT at these facilities was calculated as 1528 h per year. A final list of 45 WC and aligned AS was obtained and provided the necessary contextualization. A WISN based framework, and a Microsoft Excel tool (calculator) resulted. Calculated average dietitians’ requirements were 24.59 and 24.23 for WISN software and the excel tool respectively. Conclusion The WISN methodology is a versatile tool that allows for the development of context and cadre specific staffing norm implementation frameworks and tools. The developed tool is valid and contextualized to determine the specific need for dietitians at SA central and tertiary public hospitals. These results will help policy makers to plan and forecast dietetic staffing needs at a macro level.https://doi.org/10.1186/s12913-025-12286-8DietitianFrameworkSouth AfricaStaffing normToolWorkload Indicators of Staffing Need
spellingShingle Vertharani Nolene Naicker
Jane W. Muchiri
Keshan Naidoo
Modiehi Heather Legodi
A Workload Indicators of Staffing Need (WISN) based framework and implementation tool for dietitians at South African central and tertiary public hospitals
BMC Health Services Research
Dietitian
Framework
South Africa
Staffing norm
Tool
Workload Indicators of Staffing Need
title A Workload Indicators of Staffing Need (WISN) based framework and implementation tool for dietitians at South African central and tertiary public hospitals
title_full A Workload Indicators of Staffing Need (WISN) based framework and implementation tool for dietitians at South African central and tertiary public hospitals
title_fullStr A Workload Indicators of Staffing Need (WISN) based framework and implementation tool for dietitians at South African central and tertiary public hospitals
title_full_unstemmed A Workload Indicators of Staffing Need (WISN) based framework and implementation tool for dietitians at South African central and tertiary public hospitals
title_short A Workload Indicators of Staffing Need (WISN) based framework and implementation tool for dietitians at South African central and tertiary public hospitals
title_sort workload indicators of staffing need wisn based framework and implementation tool for dietitians at south african central and tertiary public hospitals
topic Dietitian
Framework
South Africa
Staffing norm
Tool
Workload Indicators of Staffing Need
url https://doi.org/10.1186/s12913-025-12286-8
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