Invest in nursing to avoid readmission penalties

Hospitals should invest in nursing to reduce readmissions as a new Health Affairs study shows hospitals with higher nurse staffing had lower odds of receiving penalties for excess readmission rates.

Researchers looked at fiscal year 2013 penalty data for 2,826 adult acute care hospitals coupled into 1,413 high-low staffing pairs. They found hospitals with higher nurse staffing levels had 25 percent lower odds of Medicare readmission penalties compared to their lower-staffed counterparts.

Even when researchers closely matched hospitals on factors, such as patient population characteristics, well-staffed hospitals were significantly less likely to get hit with penalties than hospitals with lower staffing.

High-staffed hospitals had an average of eight registered nurse hours per adjusted patient day while low-staffed hospitals averaged about five registered nurse hours per adjusted patient day, according to the study. What's more, with each additional nurse hour per adjusted patient day, hospitals can lower their odds of being penalized by 10 percent.

As hospitals look for ways to curb excessive readmissions and avoid Medicare payment reductions, the Health Affairs study suggests hospital administrators focus on the staffing levels and workload of nurses--who perform the fundamental readmission reduction efforts of discharge planning, patient education, complication observation and intervention, knowledge assessment, and care coordination.

"Nurses who work in well-staffed hospitals have the time and the resources to more effectively execute the care processes that influence readmissions," the study states. "They are also better equipped than other nurses to monitor for complications and adverse events that increase readmission risk."

Hospital nurse staffing levels also directly correlate with pediatric readmissions, FierceHealthcare previously reported. A May study in the journal BMJ Quality and Safety in Health Care found children with common medical and surgical conditions treated in hospitals meeting a staffing benchmark of no more than four patients per nurse were significantly less likely to be readmitted within 15 to 30 days.

For more:
- here's the study abstract