"When you think of nurse staffing studies, you can't take a lot of the results as seriously as you might otherwise because they're comparing apples to oranges," McHugh says. "We were able to take a measure of nurse staffing based on hours-per-patient-day and create matched pairs across the country. Each hospital had basically a twin, as similar as possible in all manner and respect except for nurse staffing."
The researchers made sure the hospitals were matched in terms of low-income patients, case mix, and teaching status. Doing so eliminated as many other variables as possible that could affect readmissions other than nurse staffing. It also allowed them to compare and isolate the effect of a much higher level of nurse staffing.
Still, left to CEOs and other upper management team members is what action to take from what the study reveals. The highest performing hospitals differed with the lowest performing ones by about three hours of nursing time per patient per day, "which is a lot," concedes McHugh, who adds, "we didn't go into calculating the financial trade-off."
That raises another difficult point: the financial implications.