equitable assignment flowchart

Equitable Assignment: Everything You Need to Know

An equitable assignment is one that does not fulfill the statutory criteria for a legal assignment, but is binding and upheld by the courts in the interest of equability, justice, and fairness. 3 min read updated on February 01, 2023

An equitable assignment is one that does not fulfill the statutory criteria for a legal assignment, but is binding and upheld by the courts in the interest of equability, justice, and fairness.

Equitable Assignment

An equitable assignment may not appear to be self-evident by the law's standard, but it presents the assignee with a title that is protected and recognized in equity. It's based on the essence of a declaration of trust; specifically, essential fairness and natural justice. As long as there is valuable consideration involved, it does not matter if a formal agreement is signed. There needs to be some sort of intent displayed from one party to assign and the other party to receive.

The evaluation of a righteous equitable assignment is completed by determining if a debtor would rationally pay the debt to another party alleging to be the assignee. Equitable assignments can be created by:

• The assignor informing the assignee that they transferred a right to them
• The assignor instructing the other party to release their obligation from the assignee and place it instead on the assignor

The only part of an agreement that can be assigned is the benefit. Generally speaking, there is no prerequisite for the written notice to be received or given. The significant characteristic that separates an equitable assignment from a legal assignment is that most of the time, an equitable assignee may not take action against a third party. Instead, it must rely on the guidelines governing equitable assignments. In other words, the equitable assignee must team up with the assignor to take action.

The Doctrine of Equitable Assignment in Wisconsin

In Dow Family LLC v. PHH Mortgage Corp ., the Wisconsin Supreme Court issued in favor of the doctrine of equitable assignment. The case was similar to many other foreclosure cases, except this one came with a twist. Essentially, Dow Family LLC purchased a property and the property owner insisted the mortgage on the property had been paid off. However, in actuality, it wasn't. 

Prior to the sale, the mortgage on the property was with PHH Mortgage Corp. When PHH went to foreclose on the mortgage, Dow Family LLC contested it. There was one specific rebuttal that caught the attention of the Wisconsin Supreme Court. The official mortgage on record was with MERS, an appointee for the original lender, U.S. Bank.

Dow argued that PHH couldn't foreclose on the property because the true owner was MERS. Essentially, Dow was stating that the mortgage was never assigned to PHH. Based on this argument, PHH utilized the doctrine of equitable assignment.

Based on a case from 1859, Croft v. Bunster, the court determined that the security for a note is equitably assigned when the note is assigned without a need for an independent, written assignment. Additionally, Dow contended that the statute of frauds prohibits the utilization of the doctrine, mainly because it claimed every assignment on a property must be formally recorded.

During the case, Dow argued that the MERS system, which stored the data regarding the mortgage, was fundamentally flawed. According to the court, the statute of frauds was satisfied because the equitable assignment was in accordance with the operation of law. Most importantly, the court avoided all consideration regarding the MERS system, concluding it was not significant in their decision. 

The outcome was a major win for lenders, as they were relying on the doctrine specifically for these types of circumstances.

Most experts agree that this outcome makes sense in the current mortgage-lending environment. This is due to the fact that it is still quite common for mortgages to be bundled up into mortgage-backed securities and sold on the secondary market.

Many economists claim that by not requiring mortgages to be recorded each time a transfer is completed, the loans are more easily marketed to investors. Additionally, debtors know who their current mortgage company is because the new lender must always notify the current borrower in order to receive payment. It was determined that recording and documenting the mortgage merely provides a signal to the rest of the world that the property owner secures a debt.

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Why is equity important in assignment design?

Many instructors have taken a renewed interest in the equity and fairness of their courses. Although all aspects of teaching and learning merit such a focus, it is particularly important in the area of assignment design. Assignments designed with equity in mind ensure that all students have optimal conditions in which to demonstrate their learning; this in turn helps faculty evaluate students’ knowledge and skills fairly and accurately. 

What makes an assignment equitable?

Among the features of assignment that can make assignments more equitable are flexibility and variety, an emphasis on the process of learning, application of principles of Universal Design for Learning (UDL) , transparency, and equitable grading. Below we define each of these terms and provide some specific examples.

Flexibility and Variety

Constructing assignments with flexibility and variety in mind can allow students to show what they have learned regardless of their academic strengths or familiarity with particular assignment types. These features require that faculty think through how each assignment (in all its variations) aligns with the learning outcomes for the course, to ensure that all students have an opportunity to achieve those outcomes.

• Within an assignment, allow students to choose from several different formats for their response that all meet the assignment goals
• Across a course, provide a variety of types of assignments
• If a major project includes several different components (a written paper and an oral presentation, for example), allow students to determine the weight of each component
• If you must use multiple-choice exams to assess students’ learning, consider offering an alternative assignment for students who don’t test well, or who have slow internet connections

An Emphasis on the Process of Learning

With careful assignment construction, instructors can hep students engage in and prioritize the process of learning. This will not only improve students’ performance; it can also increase their time on task, which can benefit all students.

• Adopt a growth mindset in your teaching by emphasizing that students can succeed in your course with hard work and effort
• Give students frequent opportunities to demonstrate their learning, including low-stakes chances to practice skills and assess their own progress toward course goals
• Scaffold students’ work to facilitate building skills, and offer frequent feedback on students’ progress
• Allow students to revise their work to respond to your feedback
• Help students reflect on the processes they used to respond to major assignments or to study for exams

Application of Principles of Universal Design for Learning (UDL)

UDL is a set of principles to guide the creation of inclusive and accessible courses and learning experiences. When these principles are applied to assignment design, they can benefit all students, not only those with disabilities.

• Provide assignment instructions in writing and verbally
• Simplify the navigation in your course Canvas site so students can find assignments easily
• Give students some choice in how they can show their learning
• Consider alternatives to traditional multiple-choice exams
• Provide ample time for exams and online assignments to be completed

Transparency

This is the concept of making clear to students the purpose of assignments and activities and how to succeed on them. Being transparent with students ensures that all students can succeed, not only those with privileged educational backgrounds.

• For assignments that include a rubric, share it with students when they start to work on the assignment; you can even involve students in rubric creation
• Be transparent in your assignment design by specifying in each assignment its purpose, the process or task students should engage it, and the criteria that will be used to evaluate it
• The concept of transparency in teaching includes other pedagogical strategies in addition to transparent assignment design. For more information, see the page on Transparency in Learning and Teaching (TILT) .

Equitable Grading

Along with equitable assignment design, faculty can grade students equitably on the basis of their learning and performance, and without allowing factors such as race, ethnicity, socio-economic status, abilities, rural/urban location, or internet access to influence grades. In this way grades can be used not to sort and rank students, but instead to guide all students to achieve course learning outcomes.

• If you will use a rubric or grading standards to evaluate students’ work, share it when making an assignment so that all students understand how their work will be evaluated
• Provide feedback along with grades to help students understand the strengths and weaknesses of their work and how to improve it
• Avoid “magical grading”: grading on the basis of factors or traits that are not articulated, or that are assumed to be “implicit”
• Consider whether it is more equitable to weight assignments done early in the semester more lightly and those done later more heavily, after students have had a chance to learn about your standards and expectations 

For more help with applying any of these concepts to your teaching, contact the CITL .

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How do I ensure my assessments are equitable and inclusive for all students?

Our students come to college from diverse contexts with variable experiences. Some students arrive with or develop physical and mental health challenges. Because of this, it is important to consider if our assessments are equitable and inclusive for all. This section provides some suggestions and strategies to consider when creating assessments. 

• Use multiple assessment types
• Provide reasonable accommodations and deadline expectations
• Provide options/choices for students to demonstrate their learning
• Ensure your materials are accessible
• Use clear language that is understood by all
• Be specific and transparent about student expectations
• Counter any implicit biases when creating and grading assessments 

+ Use multiple assessment types

Use more than one assessment type to provide students with different opportunities to demonstrate their knowledge. Variability in students’ cultural, linguistic, and disciplinary backgrounds affect their interpretation of, performance on, and motivation for engaging a given assessment type. 

Students with Attention Deficit Hyperactivity Disorder (ADHD) may have working memory issues that would make taking long multiple choice assessments challenging. If this is the only way students are assessed in a course, those students will have more demands and fewer benefits on assessments. Additionally, if writing long responses to posed questions is the only option for assessment, students who are not native English speakers will have more demands and fewer benefits, especially if they do not have access to aids such as a glossary or dictionary or if there is time pressure to respond (Adapted from  UDL and Assessment ).

Thus, providing varied forms of assessment helps level the playing field for all students.  Universal Design for Learning  is an educational framework to guide the design of learning aims, assessments, materials, and methods while keeping a diversity of learners in mind. This approach recommends that assessments provide multiple means of representing and assessing knowledge for students.

Web resource:  UDL and Assessment  (Universal Design for Learning in Higher Education)

+ Provide reasonable accommodations and deadline expectations

Students in our courses may come with requests for disability accommodation from the Disability Resource Center (UMTC) or requests for exam rescheduling in accordance with University policy . The Disability Resource Center lists the following as the most requested accommodations for students:

• Extended testing time
• Short breaks during testing 
• Modified deadlines
• Semi-private testing
• Modified attendance

Note that three of the five requested accommodations are related to assessments. One way to approach this as an instructor is to make accommodations for individuals on a case-by-case basis guided by their accommodation request letter. In these cases, instructors are asked to consider ways to meet the accommodation request while still ensuring the student demonstrates the ability to meet course learning aims. 

Another way to approach this is to design your assessments with accessibility in mind, thereby eliminating the need for some students to make accommodation requests. This can be done by clearly outlining your learning aims and assessing for competency rather than the capacity to demonstrate knowledge in a particular way.

Suggestions to consider

• Increase the time allowed for all students to take assessments or move away from timed exams
• Build flexibility into the course structure, such as allowing students to drop one or more of their lowest quiz or assessment scores
• Provide an exam window (especially for online exams) in which a student can begin their exam at any point over a period of time, for example, over the period of 3 days, or a take-home exam over the period of several days.
• Use a "deadline window" in which a student can choose what date they will turn in their assignment over a period of time
• Clarify expectations with respect to deadlines for assignments and assessments in the syllabus
• Tell students why some deadlines are firm - e.g. students need to be evaluated on one skill before moving on to the next skill

With either approach, instructors do not need to abandon appropriate high standards in their course, but rather prevent unnecessary challenges and stress related to assessing course outcomes. For example, is a timed exam necessary for students to demonstrate competency? 

Web resources

• Testing information for instructors  (Disability Resource Center - UMTC)
• Teaching with Access and Inclusion

+ Provide options/choices for students to demonstrate their learning

For each assessment type you use, consider offering students some range of choices in how to complete it. A key Universal Design for Learning principle suggests that we provide students with multiple means for action and engagement in our assessments. You might begin this consideration by reviewing a planned assessment with these questions in mind:

• Will students be asked to communicate their understanding of new ideas/concepts? In what ways? Will they need to speak, write, or draw? Are there alternative ways students could communicate their understanding?
• Will students be asked to demonstrate an action or skill? Is it essential to meeting the learning aim that students physically demonstrate the skill or action? Are there alternative ways students can demonstrate their mastery?
• Is it critical that students perform the task in a time-limited setting without aids or can certain aids be available to students?

Consider which actions are relevant to the learning aims being measured and which ones can be supported or varied to gain an accurate picture of what each student has learned.

Web resource: UDL and Assessment  (Universal Design for Learning in Higher Education)

+ Ensure your materials are accessible

Ensure your assessments are accessible to students with disabilities. The United States Department of Education (US DOE) Office for Civil Rights defines that students with disabilities “must be provided the opportunity to: acquire the same information, engage in the same interactions, and enjoy the same services as students without disabilities, with substantially equivalent ease of use.”

Web resource: Technology Accessibility  (US DOE Office of Civil Rights policies)

7 Core Skills of Accessibility

Familiarize yourself with the UMN 7 Core Skills of Accessibility in order to create digital materials that are accessible and can be easily used by as many learners as possible:

• Add alternative text or “alt text” to every image that conveys meaning.
• Ensure a strong color contrast between foreground and background text.
• Structure your document, webpage, or Canvas Site using paragraph styles or headings tags.
• Make links concise, descriptive, and meaningful out of context.
• Present key concepts as lists instead of a wall of text when possible.
• Create tables that are simple, rather than complex, have an identified header row, and include a table summary, either as a caption or as alt text. 
• Ensure videos include accurate captions and audio descriptions and audio-only content includes an accurate transcript - Video and Audio.

Consider also accessibility of print materials and physical accessibility when designing and administering your assessments.

+ Use clear language that is understood by all

Examining language usage and choice is an ongoing process, as we learn about emerging changes, inclusive terminology, and evolving student contexts.

As you evaluate your assessments and instructions for clear, understandable language here are some questions to consider:

• What happens when my assessment contains references that may not be understood by students from different cultures or for whom English is not their first language?
• What happens when my exam and assignment descriptions are unclear or confusing to students?
• Have I proofread my assessments, especially timed exams, for typos or mistakes in grammar?
• What happens when my language choices seem disrespectful to students?
• What happens when I don't offer and welcome opportunities for students to seek clarification and for me to receive feedback on my language choices?
• What happens when I am not open to adapting my language choice based on changing recommended practices?

Web resource: Bias-Free Language (APA Style Guide)

Video resource: Inclusive Language (Association Of College And University Educators Inclusive Teaching Practices Toolkit)

+ Be specific and transparent about student expectations

“In the real world-unlike schools-there is little if any secrecy about the goals or the criteria for success.”  – Wiggins, 2005 p 154

Inform students of the What, Why, and How of your assessments

What must students be able to do on the assessment?

Rather than telling students what will be “on” an assessment, tell them what they should be able to “do” in the assessment. Students should know which learning aims will be tested on an assessment, the standards, and level of detail required. For example, instead of telling students that the exam will cover chapters 10 – 14, reframe this in terms of the appropriate learning outcomes e.g. For the following list of drugs be able to identify their molecular target, their effect on the target, the role of the target in a physiological process, and intended and unintended effects of the drug. This allows students to prepare in a way that aligns their efforts with your stated learning aims.

Additional examples:

• Learning aims study guide for civil engineering assessment – Dave Saftner - UMN
• Learning aims study guide for chemical engineering assessment – Michael Prince - Bucknell

Why does the assessment support their learning? 

This is your opportunity to inform students of the connection of the assessment to their learning. You can also describe the benefits of completing an assessment. For example: this portfolio provides evidence of your skills and learning which some students have used in job application materials.

How should they complete the assessment?

Provide students with the format and logistics for the assessment using clear language that is understood by all.

+ Counter any implicit biases when creating and grading assessments

Implicit bias refers to the unconscious attitudes, stereotypes, and reactions we all have that may affect our behavior. These biases may affect how we interact with students and may be reflected in the assessments that we create and grade. To design assessments that promote learning for all students it is useful to consider if our unconscious biases may result in assessments that are not equitable and inclusive for all students. Below are some suggestions to consider when creating and grading assessments.

When creating assessments:

• Include diverse representations of people and ways of knowing.
• Consider which students are privileged with any approach that you chose e.g. native English speakers for oral or written assessments.

When grading assessments:

• Ask yourself if you can fairly and equitably grade the assessment approach that you choose.
• Using a rubric to grade (which is provided to students ahead of time).
• Removing student names if possible when grading (Moss-Racusin, 2012).

Web resources: 

• Designing and Using Rubrics  (Center for Writing)
• Creating and using rubrics in Canvas  (Instructure Community)
• Awareness of Implicit Biases (Yale Poorvu Center for Teaching and Learning)
• Implicit bias association test  (Project Implicit)

Reference: Moss-Racusin, C. A., Dovidio, J. F., Brescoll, V. L., Graham, M. J., & Handelsman, J. (2012). Science faculty’s subtle gender biases favor male students . Proceedings of the National Academy of Sciences , 109(41), 16474-16479.

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Equitable assignment

Practical law uk glossary 2-107-6540  (approx. 3 pages).

• The assignor can inform the assignee that he transfers a right or rights to him.
• The assignor can instruct the other party or parties to the agreement to discharge their obligation to the assignee instead of the assignor.
• General Contract and Boilerplate
• Breach of Lease Covenants
• Security and Quasi Security

What is the significance of an equitable assignment in the context of the assignment of future rights under a contract (or a chose in action)?

An assignment is the transfer of a right or an interest vested in one party (assignor) to another party (assignee). The effect of a valid assignment is to entitle the assignee to demand performance of a contractual obligation.

Assignments may be legal or equitable.

A legal assignment is one which meets the requirements set out in section 136(1) of the Law of Property Act 1925 (LPA 1925). It must be:

absolute and unconditional and not purport to be by way of charge only

made in writing and signed by the assignor

expressly notified in writing to the obligor

Equitable assignments may arise in the following circumstances:

where there is an intention to assign, but not all of the formalities of a legal assignment are met under LPA 1925, s 136(1), the assignment may still be valid as an equitable assignment . The formalities for an equitable assignment to be effective are far less stringent

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Related legal acts:

• Law of Property Act 1925 (1925 c 20)

Key definition:

Equitable assignment definition, what does equitable assignment mean.

Assignments can occur in equity when any of the requirements of legal assignment are not satisfied.

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A new patient-acuity tool promotes equitable nurse-patient assignments

Have you ever struggled to classify a patient’s acuity level? If so, you’re not alone. Have you ever looked at your patient assignments and wondered, “Why are the assignments so unfair? How will I care for all my patients effectively?” Again, you’re not alone.

Most nurses expect patient assignments to be equitable, with each nurse bearing a fair share of the workload so all patients can receive excellent care.

Nurses’ job satisfaction depends partly on their workload and their perceived ability to deliver high quality care. Nurse-sensitive indicators (including pressure ulcers, falls, medication errors, nosocomial infections, pain management, and patient satisfaction) depend largely on nursing care and are affected by nurses’ ability to recognize and intervene when a patient’s condition changes. Nursing workloads directly influence a nurse’s ability to assess thoroughly and promote excellent patient outcomes. When patient assignments aren’t equitable, nurses may feel inadequate and frustrated.

Problems also can arise when all nurses are assigned the same number of patients without regard for acuity levels. Yet determining patients’ acuity to promote more equitable assignments can be challenging. Some hospitals or nursing units use an established acuity tool. Others rely on charge nurses’ judgments of patient acuity.

Our nurses were getting restless

At Indiana University Health Ball Memorial Hospital in Muncie, we moved our progressive care unit (PCU) to a newly constructed area of our regional medical center. A short time later, we noticed increases in patient volumes, comorbidities, device support, and overall acuity. The patients’ nursing-care requirements varied widely, so assigning the same number of patients to all nurses would mean unequal assignments.

Although were using an acuity assessment tool, our increasingly dissatisfied nurses deemed it ineffective. It called for nurses to rank each patient as a 1, 2, or 3 based on their individual perception of the patient’s status or difficulty of care required. But the tool wasn’t providing useful information because nurses’ perceptions varied; also the cultural norm tends to make nurses rate most patients a 2. In addition, when more staff nurses were needed, we lacked an objective measure to make a case for obtaining additional staff. When our hospital tested a new nurse-satisfaction survey, nurses’ discontent with their workload became apparent.

Then a PCU direct-care nurse approached the unit-based council (UBC) and asked for an evaluation of our acuity tool. The nurse manager and UBC agreed that equitable patient assignments and adequate unit staffing could be addressed by improving the tool. Following the Iowa model of evidence-based practice (EBP), the UBC formed a team of staff nurses, charge nurses, unit manager, clinical nurse specialist, and nurse researcher to explore the inquiry.

What the evidence told us

The team’s literature review found a limited amount of research pertaining to acuity tools for PCUs, even though hospital expenses decrease and high-quality nursing care increases when leaders are empowered with better, more detailed knowledge of patient acuity and nursing workloads. A recurrent theme in the literature: nurses’ voices add value to processes and nurses should be involved in assessing their own workloads and making decisions about resources. Evidence also suggested that involving staff in developing an acuity assessment tool would yield a valued, more efficient instrument that could improve nurse satisfaction and job retention.

Formulating a plan

During our literature review, we found a tool to adapt for our adult PCU. On a flip chart in the nurses’ lounge, we displayed our existing tool alongside the new tool we’d revised from the literature search. Staff viewed both tools and provided input into what made a patient’s care difficult, time-consuming, or complex. This gave us a better picture of PCU patients and helped us ensure all tasks were represented, from the least to the most time-consuming. Brainstorming meetings clarified key elements of acuity that guided continued evolution of the new tool.

Tool-development strategies

In our new tool, criteria categories included complicated procedures, education, psychosocial/therapeutic interventions, number of oral medications, and complicated I.V. drugs and other medications. Rating options on the tool run from 1 through 4, with 1 indicating low acuity and 4 indicating high acuity. Ratings are based on nursing time needed to complete a task, emotional and physical energy expenditure required, expertise required, frequency of tasks and interventions, and follow-up assessments related to a specific task. Ratings for all five criteria categories are summed up to obtain a total acuity score for each patient, ranging from 1 to 60. Then the total scores are clustered into acuity category scores, which range from 1 to 4, with 1 being the lowest acuity and 4 being the highest. (See Acuity criteria categories .)

Now we were ready to test the new tool. Initially, charge nurses from each shift tested it with the same patients on different shifts. When we found that scores between shifts weren’t congruent, we tested the tool again, with charge nurses on the same shift assessing the same patients separately. This trial yielded an inter-rater reliability of 85%—an acceptable congruency level across nurse raters.

This trial provided insight into acuity differences between shifts and helped determine how to use the tool. With our previous acuity tool, tasks and procedures of the rater’s shift determined acuity, with no consideration of upcoming tasks or procedures for the next shift. So for the new tool, the team and staff agreed nurses would proactively score acuity for the oncoming shift by calculating current and projected needs and medications.

Measuring outcomes

We identified three outcome measures as indicators of the effectiveness of the new acuity approach.

• First, the team developed an eight-item survey to measure nurse satisfaction with the new acuity assessment process, which nurses completed 1 month before the new process began and then 1 month, 6 months, and 12 months later.
• Next, the team identified items on the standardized annual employee engagement and satisfaction survey, specifically targeting workload and perception of quality of care delivered.
• Finally, we tracked nurse sensitive indicators affected by workload, including falls and hospital-acquired pressure ulcers.

Translating scores into patient assignments

To translate acuity scores into equitable patient assignments, charge nurses collected the acuity tools that direct-care nurses completed for each patient, and calculated total acuity scores and acuity category scores near the end of their shift. Then the charge nurses designed nurse-patient assignments by considering both the category score from 1 to 4 and the total acuity score of 0 to 60 for each patient, aiming to keep category scores balanced across nurses. Charge nurses also considered the geographic location of rooms on the unit, need for continuity of care, and congruency between nurses’ expertise and patient needs. (See Current acuity tool on last page .)

Unit-wide rollout

Before we rolled out the new tool, direct-care nurses on our team provided education to all PCU nurses. Teaching strategies included showing video clips of patient scenarios, presenting case studies so nurses could practice using the tool, and playing a game-show exercise to stimulate discussion of the benefits of acuity scoring. Nurses voiced favorable responses to the new tool, specifically the benefits of empowerment, assurance of quality care, patient safety and satisfaction, nurse retention, and equitable assignments. The team encouraged staff to provide feedback on the new process and expect revisions to ensure its effectiveness and sustainability.

To hardwire the new acuity assessment process, team members rounded on nurses each shift for 1 week and then three times monthly. The team answered questions, audited acuity scores, and coached nurses to achieve a highly standardized approach to scoring. During orientation, preceptors trained newly hired nurses to use the acuity assessment tool.

Charge nurses kept a log of assignments, acuity scores, and overall unit activities, overtime, and informal comments on workload. In huddles held daily for the first week, charge nurses and the nurse manager reviewed acuity scores and the process. A numerical benchmark emerged as an indicator for requesting more staffing, based on total acuity scores and acuity category scores of all patients on the unit.

Evaluation and sustainability

At the end of the first month, scores on surveys of nurse satisfaction with the new acuity assessment process showed marked improvement in nurses’ reports of the equity of patient assignments (7% satisfaction before rollout, 55% satisfaction after) and the consistency with which the acuity assessment process occurred (21% consistency before rollout, 89% consistency after). Almost 80% of nurses reported that completing the new acuity tool wasn’t a waste of time. The team implemented suggestions for refining the process and set a target goal of 85% nurse satisfaction by the 6-month evaluation.

The sustainability plan for year 1 calls for quarterly reevaluation of the acuity assessment process and semiannual reevaluation thereafter, including scoring processes, staffing level benchmarks, nurse satisfaction per survey, and nurse-sensitive outcomes. It also calls for nurses to review reports of outcome data regularly during staff meetings. When revisions are indicated, the team will provide additional education.

As the process of creating ideal nurse-patient assignments evolves, the team will explore the benefits of the synergy model, which matches nurses’ strengths and competencies with patient and family characteristics. The team may conduct qualitative research studies to better understand the complex judgments charge nurses make when creating nurse patient assignments, with the goal of standardizing the process for sustainability and optimal outcomes.

In evaluating the overall projects  experience, team members listed  lessons learned and captured key  ideas to use in future projects. (See  Acuity tool: Lessons learned by clicking the PDF icon above). The  team validated usefulness of the  Iowa model in developing the tool  and process, and recommended  adopting a model for translating evidence  into practice. Nurses on the  team reflected that a highly satisfying  aspect of the project was identifying  a clinical issue and playing an  active role in addressing it as valued  partners in the change process.

Selected references

Choi J, Choi JE, Fucile JM. Power up your staffing model with patient acuity. Nurs Manage . 2011;42(9):40-3.

Duffield C, Diers D, O’Brien-Pallas L, et al. Nursing staffing, nursing workload, the work environment and patient outcomes. Appl Nurs Res . 2011;24(4):244-55.

Fram N, Morgan B. Ontario: linking nursing outcomes, workload and staffing decisions in the workplace: the Dashboard Project. Nurs Leadersh (Tor Ont). 2012;25(Spec No 2012): 114-25.

Hardin SR, Kaplow R, eds. Synergy for Clinical Excellence: The AACN Synergy Model for Patient Care . Sudbury, MA: Jones and Bartlett; 2005.

Harper K, McCully C. Acuity systems dialogue and patient classification system essentials.  Nurs Adm Q . 2007;31(4):284-99.

Titler MG, Kleiber C, Steelman VJ, et al. The IOWA model of evidence-based practice to promote quality care. Crit Care Nurs Clin  North Am. 2001;13(4):497-509.

The authors work at Indiana University Health Ball Memorial Hospital in Muncie. Michelle Kidd is a critical care clinical nurse specialist. Kimberly Grove, Melissa Kaiser, and Brandi Swoboda are direct- care nurses in the progressive care unit (PCU). Ann Taylor is nurse manager in the PCU.

29 Comments .

Hello, I would like to request permission to utilize the patient acuity tool in my DNP project.

Hello, I would like to request permission to use this tool as a reference in my BSN assignment.

Hello Kaitlynn, The authors of the article are happy to grant others permission to use the tool. Please be sure to credit the source. Best, Cheryl Mee MSN, MBA, RN, FAAN, Executive Editorial Director, American Nurse Journal

Would like permission to use this tool for our Acute Care Floor in northern MN. Having a lot of the same issues discuss prior to your implementing…. Assignment and staffing inconsistencies, teams of 5 plus, multiple unsafe staffing scenarios. Think this would be a huge help! Thank you!

Hi, Our unit (surgical unit) are currently doing brain storming and gathering ideas on how to improve our nurse:patient assignment. We are trying to develop a patient acuity tool which would suit our patient care environment. Hoping we could reference and use your tools with your permission.

Very much appreciated.

can you share your acuity tool. We are also trying to come up with a solution instead of the admin. staffing by census…..

Can you email me at [email protected] please to discuss? Thanks!

Yes, you may.

Hi, I would love to use this as a reference to adapt an appropriate acuity tool for the medical surgical unit at our hospital. I am hoping to be granted permission to use , with appropriate citations.

Dear Micaela,

The authors of the article are happy to grant others permission to use the tool. Please be sure to credit the source.

Cynthia Saver, MS, RN

Firstly, we would like to congratulate the authors of the New Tool and we wish to be granted to use the tool with citation of the authors. What about Chemotherapy, is it under the complicated IV drugs but it is not specified? Hope to be clarified about it. Thank you.

Ruhaina Ladja,

Thank you for your interest in the acuity tool. I would venture to say chemotherapy would be included in complicated IV drugs, but in the units for which we first developed this tool the nurses did not administer chemotherapy.

Thanks again, Michelle J Kidd, MS, APRN, ACNS-BC, CCRN-K

Hi there, I am seeking permission to utilize this patient acuity tool for our evidence-based project on our IMU/ICU unit. Thank you so much.

The authors of the article are happy to grant others permission to use the tool. Please be sure to credit the source. Cynthia Saver, MS, RN, Editorial director for American Nurse Journal

Does anyone have the contact information for the authors of this tool? I would like to use this tool for my DNP project and need permission to use.

I would like to request fro your permission to utilize this tool for a pilot project initiative in my department.

The authors of the article are happy to grant others permission to use the tool. Please be sure to credit the source. Cynthia Saver, MS, RN, Editorial director for American Nurse Journal.

I am requesting permission to use this tool Thank you

I am requesting permission to use this tool on my Med/Surg floor

Thank you, Tiffany Brisken, BSN, RN, PHN

I would love to use your tool on my floor which is cardiac. I am researching and hoping this will work for us.

Wendee, the author of the article is happy to grant permission for you to use the tool.

Cynthia Saver, MS, RN, Editorial director for American Nurse Journal.

Looking to obtain permission to use tool for QI project. Please let me know who to contact.

We did contact the authors, and they gave permission for the use of the tool. Thank you for your inquiry!

-Lydia Kim, Digital Content Editor at American Nurse Today

Hello Can you help me get an acuity tool that helps nurses?

Hello Ms. Kidd,

Can I get permission to use your acuity tool for my research? Hoping for your favorable response.

Kathy Carandang

I agree! I would love to see a follow up!

Any chance to see this “patient-acuity” tool? I am working on developing one for my unit.

Awesome, this is a HUGE help.

Would love to see the follow up on this article! The results only discuss nurse satisfaction after 1 month. What happened to the results from the other nurse-sensitive indicators discussed?

I would like to use your tool for my DNP project, how would I go about contacting the right person(s) to get permission? I would appreciate your feedback.

Comments are closed.

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