Shrink Readmissions by Adding Nurses

Philip Betbeze, October 11, 2013

Bumping up nurse staffing levels by three nurse hours per patient day provides a demonstrable and marked reduction in hospital readmissions. But the financial implications of doing so are tricky.

Changing the business model in healthcare from payment for outcomes rather than for volume of services rendered is critical to reducing costs and improving quality in healthcare. But so far, the financial incentives for re-engineering the business model are not significant enough to force a rapid transition.


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Still, we may be heading in the right direction—for instance, in nurse staffing.

Nurse staffing levels are always a critical point of contention between staff and management. CEOs rightly keep a close eye on labor costs, and nurses are among the most expensive of hospital labor. States, labor unions, and others have attempted to tell CEOs how they should manage nurse staffing ratios, and in many circumstances, they have succeeded in establishing minimum levels.

But how much is enough?

Nurse staffing ratios have been studied backwards and forwards to determine their impact on patient care, but a recent study in Health Affairs has finally linked nurse staffing levels to outcomes. According to lead researcher Matthew McHugh, PhD, JD, MPH, RN, hospitals with higher nurse-to-patient staffing ratios have lower odds for being penalized for excessive readmissions in CMS's Hospital Readmissions Reduction Program, which is estimated to reduce hospital payments by roughly $280 million in 2013.

Philip Betbeze

Philip Betbeze is the senior leadership editor at HealthLeaders Media.

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