When revenues fall, hospitals stop investing in the biggest budget expense: nurses. That's a bad short-term solution to a long-term problem. It's time we change the way we think about hospital staffing.
"When we look at all the problems we have [in healthcare right now], what is the first thing we do? Start slashing nurses," says Kathy Douglas, MHA, RN, president of the Institute for Staffing Excellence and Innovation, CNO of API Healthcare, and a board member of the journal Nursing Economic$, which has devoted a whole issue to examining the evidence around nurse staffing.
"Healthcare executives and nurse leaders need to be more aware of thinking about staffing and scheduling from a bigger perspective so we understand all of the financial implications," she says. "How do we manage our way effectively through the maze and chaos we are in right now?"
To deal with ongoing challenges presented by value-based purchasing and healthcare reform, executives must acquaint themselves with studies demonstrating how nurse staffing affects a hospital's overall performance and base staffing decisions on evidence.
"What we know from research and experience is that there are very direct links between staffing and length of stay, patient mortality, readmissions, adverse events, fatigue-related errors, patient satisfaction, employee satisfaction, and turnover," says Douglas. "All of these things have studies that directly relate them to staffing. And all have the potential for significant costs. When we don't look at the relationship between our LOS and our unreimbursed never events and our staffing, we're not looking at the whole picture."
Too few hospitals track staffing data in comparison to these big issues.