Increased nurse staff levels tied to lower odds of Medicare readmissions penalties, s

Nurses Activism

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Nursing unions wanting higher staffing ratios have more ammunition thanks to a new study concluding that increasing nurse staffing levels could help hospitals avoid Medicare penalties for avoidable readmissions.

The study covered readmissions of Medicare patients who suffered heart attacks, heart failure or pneumonia. It appears in the October issue of Health Affairs. ...

... The researchers, led by Matthew McHugh, an associate professor at the University of Pennsylvania School of Nursing, looked at nurse staffing levels and readmission data from 2,826 hospitals. They found that hospitals with high nurse staff levels, as considered by researchers, had 25% lower odds of being penalized compared to facilities with lower nurse-staffing ratios. Higher-nurse staffed hospitals also had 41% lower odds of receiving the maximum penalty for readmissions. The study used American Hospital Association staffing data for the study.

The research team estimated that each additional nurse hour per patient day brought 10% lower odds of receiving penalties from the Hospital Readmissions Program, the federal effort that started in October 2012 and aimed to reduce the $15 billion in annual Medicare expenditures on preventable readmissions. Hospitals paid about $280 million in penalties for preventable readmissions in fiscal 2013....

... In a news release, McHugh said nurses are responsible for many activities associated with reducing readmissions, including coordinating care, overseeing care in the hospital, planning for patients' discharge from the hospitals, and educating patients and their families about what to do when they return home.

"It's rather intuitive that when they have adequate staffing and resources to carry out these activities properly, readmission rates decline. This study strongly supports the idea that nurse staffing is one key component of healthcare delivery that hospitals can address to both improve patient outcomes and reduce the likelihood of being penalized for excessive readmissions." ...

http://www.modernhealthcare.com/article/20131008/blog/310089995

Specializes in LTC Rehab Med/Surg.

Maybe we should shift this to the "what baffles you" thread.

It certainly makes no sense.

Specializes in Adult Critical Care.

I understand the recommended ratios, and I think 4:1 or 5:1 for med surg is fine generally speaking. What I don't agree with in these studies is the concept that every single nurse you add improves patient care equally...say 5% or 10% improvement in measurement 'X.' That logically doesn't make sense. Having 6 nurses versus 5 for a 35 bed floor is a much bigger change than 8 versus 7 for a 35 bed floor. You're watering things down when you say "every extra nurse saves you 10% in readmission rates." That's like saying every cigarette cuts your life by 10 minutes based on a statistical analysis of life spans of smokers and non-smokers controlled for socioeconomic status and healthcare access; you don't actually get that 10 minutes back by not smoking 1 more cigarette.

You have to make the data applicable to the specific situation, and a lot of these studies don't do that. Administrators want to know: "What should my ideal ratios be to minimize costs?" They want research to support specific ratios for a specific acuity level. Without that focus, I think these studies won't have nearly the impact that they otherwise could have.

Specializes in Dialysis.
Administrators want to know: "What should my ideal ratios be to minimize costs?" They want research to support specific ratios for a specific acuity level. Without that focus, I think these studies won't have nearly the impact that they otherwise could have.

Which is why we, as nurses, need to give up on trying to convince a group of people whose behaviour towards safe staffing is that of a sociopath. Unless staffing is mandated by law with penalites for failure I have yet to meet a hospital adminstrator who is persuaded by any study that calls for better staffing. The CDC ten years ago linked nosocomial infections to staffing ratios but every time I have mentioned that to a nurse manager there is....silence.

Specializes in Pediatrics, Emergency, Trauma.
Which is why we as nurses, need to give up on trying to convince a group of people whose behaviour towards safe staffing is that of a sociopath. Unless staffing is mandated by law with penalites for failure I have yet to meet a hospital adminstrator who is persuaded by any study that calls for better staffing. The CDC ten years ago linked nosocomial infections to staffing ratios but every time I have mentioned that to a nurse manager there is....silence.[/quote']

Bring it to the people that matter...our patients.

Also, I thought that there were penalties for unsafe staffing in place...if so, there needs to be a way for no loopholes to occur. :yes:

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