"When hospital executives tell me there's not enough money to staff well, my first thought is 'what about the $21 billion we spend each year on unreimbursed never events?'"
Douglas believes the answers lie in using data and evidence to make effective decisions and utilizing technology in decision making. She is not a fan of blanket ratios.
"It's not that ratios are bad in and of themselves. Ratios happened, in my opinion, because hospital leadership and nursing weren't communicating well," she says. "My issue with ratios is that it assumes [staffing] is about a number. I disagree with that. It's not about a number. It's about the right number with the right qualifications with the right competencies with the right experiences."
Douglas says hospitals need to be free to examine all the factors and design a system that is flexible and allows flexing up and down based on patient needs and professional nurses' best judgment.
To do so, we need a better understanding of what the research shows about nurse staffing. We also need nurses who understand how they contribute to overall performance and who are accountable for that role.