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Nurse Staffing Costs Must Be Weighed Against Cost of Errors

Rebecca Hendren, for HealthLeaders Media, August 30, 2011

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.

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14 comments on "Nurse Staffing Costs Must Be Weighed Against Cost of Errors"


Mark (9/16/2011 at 4:59 PM)
"To do so, we need a better understanding of what the research shows about nurse staffing." The research continues to show that under staffing leads to errors, increases in infection rates and marginal care. What "better" understanding is it that we need? The need to "flex up" will only work in the unpredictable world of hospital nursing when the flex nurse is available immediately. Too often there's no one at all to do the flexing and the nurses are left runnig around like headless chikens, praying that no pt. will be harmed by shift's end.

Mike (9/14/2011 at 9:36 PM)
Bonnie, there was no mention of the staff being under educated. I believe the issue at hand was the lack of sufficient staffing, which, in turn, causes the remaining staff to be overbudened. Thus the errors and burnout.

Bonnie (9/7/2011 at 5:22 PM)
I agree that nurse staffing does effect issues such as infections, falls, med errors, etc. However far more than that, continued education and updating nurses on best practise does work. Include nurses in the quality one on one education of their peers has proven to be far more effective than online training. Involving the new grads in a concentrated quality education is very effective in preventing safety issues.