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Shrink Readmissions by Adding Nurses

Philip Betbeze, for HealthLeaders Media, October 11, 2013

Those are big numbers, but to extrapolate the financial and quality impacts of adding to nurse staffing for the roughly 5,000 hospitals around the country is impossible. Still, McHugh and his colleagues came close.

The research team was innovative in its approach. It attempted to eliminate almost any other variable in its calculations by "twinning" similar hospitals among the 2,826 hospitals studied based on nurse staffing ratios and data on readmissions penalties. In other words, researchers compared hospitals that were alike in every possible way other than nurse staffing ratios.

Here's what they found:

  • Hospitals with higher nurse staffing had 25% lower odds of being penalized than similar hospitals with lower nurse staffing ratios.
  • Hospitals with higher nurse staffing levels have 41% lower odds of receiving the maximum penalty for readmissions, compared with hospitals with lower staffing.
  • Each additional nurse hour per patient day is associated with 10% lower odds of receiving penalties under HRRP, the researchers estimate.

McHugh says he and his fellow researchers were trying to overcome methodological, as well as political issues that have clouded nurse staffing studies in the past.

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1 comments on "Shrink Readmissions by Adding Nurses"


Phyllis Kritek (10/14/2013 at 3:37 PM)
Thank you for covering this studies methodology, analysis and outcomes. I would observe that Aiken, et al demonstrated that the average cut in nursing personnel in acute care in the 90s was 9%. We concurrently cut LOS dramatically, so we had far fewer nurses caring for far more seriously ill patients. Not surprisingly, the IOM announced we had serious drug errors (To Err is Human) and that apparently patient safety was related to nursing care (Keeping Patients Safe).During longer LOSs nurses were able to do continuity of care, patient education, family education and case management. We eliminated it. We discovered this was a bad idea. Now we are trying to reinvent the wheel. The answer to this issue was available in the 90s however the apparent invisibility of nursing care created this problem. This study is best understood as a part of the history of health care in the US.