Report calls for illuminating Pennsylvania hospital staffing levels: 6 recommendations

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A recent report from Pennsylvania's Joint State Government Commission suggests that hospitals should provide patients with readily available information on nurse staffing levels so they can make informed decisions about their care.

The report was conducted by the commission, the primary and central nonpartisan, bicameral research and policy development agency for the General Assembly of Pennsylvania, in response to House Resolution No. 920 of 2014 that directed the commission to conduct a study on the staffing levels of professional bedside nurses in Pennsylvania hospitals.

In the report, the commission makes recommendations for improving the quality of care through changes to Pennsylvania laws, practices, and policies and procedures that are reflective of the available data related to professional bedside nurse staffing.

Here are the six recommendations.

1. Improve nurse workforce data collection and analysis. Currently, Pennsylvania has a mechanism for collecting data through surveys when nurses renew their licenses, which is done by the Pennsylvania Department of Health, Bureau of Health Planning in cooperation with the Department of State, Bureau of Professional and Occupational Affairs, according to the commission. So far, that mechanism has not collected information on nurses' place of employment, which would provide a means to derive measures of staffing and quality of care for each of Pennsylvania's hospitals. The commission said data should be collected on staffing, work environment, education level, burnout, job satisfaction and intent to leave, and should be directly linked with specific facilities. The Patient Safety Authority should collect data specifically related to adverse events caused by inadequate staffing, the commission said. Additionally, the commission noted that data collection is also lacking for overtime in Pennsylvania.

2. Pennsylvania should consider implementing a public reporting system for hospital staffing levels. The commission recommends that Pennsylvania, like some other states, implement a public reporting mechanism where hospitals submit staffing levels. "This type of reporting would allow patients to make informed decisions about the hospital where they choose to receive care," the commission said.

3. Hospitals should consider consistency of nurse staffing during "off-shifts,"  or nights, weekends and holidays. Currently, there are no Pennsylvania specific data that allow for comparisons across shifts in Pennsylvania's hospitals, according to the commission. However, evidence shows that patients are at higher risk for poor outcomes during "off-shift" times, often because of lower levels of staffing that frequently occur during this time, the commission said.

4. Pennsylvania hospitals should make improvements to the nurse work environment. Multiple studies show that improvements to nurse staffing will not have a significant effect on adverse events if not paired with a good work environment. Nurses in good work environments have greater autonomy, control over their practice and resources, managerial support and excellent working relationships and communication with physicians, the commission said.

5. Increase the percent of nurses in Pennsylvania with a Bachelor of Science in nursing. The commission recommended that Pennsylvania develop a plan to encourage current nurses with an associate or diploma degree to obtain a Bachelor of Science in nursing, in addition to encouraging future nurses to obtain a Bachelor of Science in nursing initially.

6. Pennsylvania should extend the whistleblower protection law to include nurses. Currently, nurses are not protected by Pennsylvania’s whistleblower protection laws. Whistleblower protections are provided in 2015 House Bill No. 476.

 

More articles on workforce and labor management:

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HealthAlliance nurses, hospital reach new contract agreement: 5 things to know

 

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