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Shrink Readmissions by Adding Nurses

Philip Betbeze, for HealthLeaders Media, October 11, 2013

"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.

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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.