With the introduction of HCAHPS scoring, government and insurers have become focused on holding hospitals accountable for patient care and satisfaction, with the hope that financial repercussions will incentivize doctors and hospitals to provide better patient care.
As the number of hospitals being penalized by Medicare due to poor patient satisfaction and outcomes grows, some facilities are cutting costs as a way to deal with the deficit. By cutting staff, especially nurses, they are not only hurting themselves but their patients as well. Nurses are often the face of the hospital and a critical link between the patient and the physician. Burdening nurses with heavy workloads or outdated equipment takes away time that could be spent caring for patients and providing oversight of their care.
According to the Agency for Healthcare Research and Quality (AHRQ), there exists a link between heavy workloads for nurses and poor patient outcomes. This is believed to lead to more patient deaths, complications and medical errors.
Although there is no proven causal relationship, a 2014 study in the American Journal of Critical Care found that nurses who were fatigued, lost sleep or couldn’t recover between shifts were more likely to regret a medical decision they had made.
In addition to heavy workloads, not having medications available when needed can also lead to poor patient outcomes. A Study of Nurse-Reported Missed Care in Neonatal Intensive Care Units by Tubbs-Cooley and colleagues found that 54.3% of nurses reported missing medications because the medications weren’t available when needed. Supplies and equipment weren’t available about half the time.
In order to combat these issues and improve patient outcomes, hospitals may have to look at making what initially can be costly changes, including increasing staff and modernizing equipment.
According to the ANA, ensuring adequate staffing levels (establishing a mandatory minimum ratio of nurses to patients) has been shown to:
- Reduce medical and medication errors
- Decrease patient complications
- Decrease mortality
- Improve patient satisfaction
- Reduce nurse fatigue
- Decrease nurse burnout
- Improve nurse retention and job satisfaction
Currently, nurses find themselves setting priorities because they know they can’t do all of their essential tasks. Increased staffing levels can aid with that situation plus give nurses more time with patients, making them more likely to catch condition changes early.
Updating equipment or adding new technologies may be costly today but will save money in the long run through:
- Decreased readmissions, which can lead to increased reimbursement
- Higher patient satisfaction, which can result in a higher HCAHPS score and more money from Medicare
- Lower mortality rate and medication errors, resulting in fewer lawsuits
- Increased nurse retention/decreased burnout meaning less money spent on hiring and training
Those institutions that are willing to invest in the short run to increase productivity and satisfaction for their nursing staff can greatly benefit over time. When looking for ways to improve quality of care and save lives, providing an environment where nurses can do their jobs without hindrance is a logical place to start.