History of MESH


Jeff Ulrich BSN, RN

(608) 279-1654



History of Patient Acuity


The concept of classification of inpatients and correlating that with the amount of time required for nursing care was originated at San Joaquin (Calif.) Hospital as part of a project funded by DHEW (Department of Health Education and Welfare) in the 1970s by four nationally renowned PhD-trained nursing professors with expertise in categorizing and quantifying nursing practice at the bedside and with a variety of different patient types. The system collected data on patient characteristics and collected data on actual nurse work sampling showing how much direct and indirect care was provided to each patient of each class over several shifts.


History of MESH

  • 1981: Five hospitals in Wisconsin made a request to the University of Wisconsin for an acuity based-staffing system
  • 1981-1984: Development of the product was initiated by Dr. Margaret Williams, a professor at the UW-Madison Nursing School and one of the professors who worked with the San Joaquin initiative.
  • 1985: PCSS module developed 
  • 1985: Semi-annual benchmarking established to ensure inter-rater reliability
  • 1995: EDLOG module developed
  • 2003: PCSS tool re-validated with assistance from Wisconsin Nurse Sampling Project
  • 2005: Entire system converted to web
  • 2005: OPSS module developed
  • 2007: BHAS module developed
  • 2011: EDLOG module interfaced with ADT data
  • 2015: PCSS module redesigned and fully interfaceable using HL7 data formatting