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The dual crises of high healthcare costs and the nursing shortage require a better understanding of inpatient nursing unit activities and, more specifically, their costs and the drivers of inefficiencies. This includes knowing not only how staff spend their time but also how much of this time is non-value-added (NVA) because wasted time leads to both high costs and nurse dissatisfaction. The authors discuss a study that determined the NVA time and costs of acute care nursing unit staff, identified drivers of high-cost NVA time, and compared activities and costs by type of nursing unit. These data have considerable implications for developing efficient and effective nursing care delivery models and for implementing process improvement and staff satisfaction initiatives.