Study Makes Business Case for Increasing RN Staffing in Hospitals
RN Ratios Save Thousands of Lives and Millions of Dollars
Mass.—A major study just published in the January/February
issue of the journal Health Affairs shows that an “unequivocal
business case” can be made for increasing the level of registered
nurse staffing in hospitals—a move that could
pay for itself in fewer patient deaths, shorter hospital stays,
and decreased rates of costly medical complications. Download
a PDF copy of the study here.
study found that if hospitals invested in increased RN staffing
at levels comparable to the top 25 percent of the nation’s
hospitals, more than 6,700 patient deaths and 4.1 million days of
hospital inpatient care could be avoided, with millions of dollars
saved each year.
new study comes at a time when Massachusetts’ policymakers
are considering legislation, H. 2663, that would set a safe limit
on the number of patients assigned to a nurse at one time. This
minimum RN staffing standard is comparable to the staffing levels
highlighted in the Health Affairs study.
Health Affairs report comes just months after the journal
Medical Care found minimum RN staffing levels more cost-effective
than clot-busting medications for heart attack and stroke, and cervical
is yet another in a long line of recently published studies that
clearly demonstrate that improving RN staffing ratios has enormous
societal benefits in terms of lives saved and reduced complications,
while also being highly cost effective,” said Beth Piknick,
president of MNA. “There is no longer any rationale for allowing
hospitals to deprive patients of the lifesaving care nurses are
capable of providing if and when nurses have a safe number of patients
to care for at one time.”
study was based on data from 800 acute care hospitals across the
country. Researchers, led by Jack Needleman, Associate Professor
in the School of Public Health at the University of California at
Los Angeles, studied several alternative scenarios for improving
patient care, and analyzed the cost-benefit of each variation in
improved RN staffing.
a patient’s perspective…using standard measures of value,
the additional costs to increase nurse staffing appear justified,”
say the study’s authors.
patient would rightfully be outraged if he or she came into a hospital
emergency room and was denied access to life saving clot busting
medications; but, every day in Massachusetts patients are being
denied the equally effective lifesaving interventions of registered
nurses, simply because hospitals refuse to invest in this less expensive
preventive measure,” Piknick explained.
to the new study, the cost of increasing RN staffing levels to provide
maximum patient safety benefits represents a mere 1.5 percent increase
in hospital costs. However, the authors estimate that hospitals
would recoup as much as half of those costs due to savings from
improved care over time.
authors of the new Health Affairs study acknowledge that
it fails to account for significant additional cost savings—identified
in a number of other studies—that might be
realized from reductions in RN turnover and from the avoidance of
additional in-stay complications. A number of studies have highlighted
the enormous cost of RN turnover driven by poor staffing levels.
One such study found that for every dollar invested to reach a 1
to 4 RN-to-patient ratio resulted in $1.20 in savings due to lower
findings mirror those of a study conducted in 2004 by Andover Economics,
Inc., a Massachusetts-based research firm that conducted the only
real-time analysis of Massachusetts hospital industry staffing levels
and the projected cost to meet requirements of pending RN staffing
legislation. This study also pegged the cost of implementing improved
RN staffing at between 1.5 and 1.8 percent, depending on the hospital.
addition to the business case for increased RN staffing levels,
the MNA points to the hospital industry’s nearly $1 billion
in profits in 2005.
and countless other studies confirm that the case for better RN
staffing has been made and the time has come to act to ensure that
a safe limit is put on the number of patients a nurse is assigned,”
Piknick concluded. “Patients are suffering and dying needlessly
because hospitals continue to under staff, while reaping ever greater
profits each year. It is clear that hospitals will not staff safely
until they are required to do so. They need to be held accountable
for investing in a safe standard of care.”