Design: The exploratory study compared refined staffing measures to common patient outcomes while controlling for individual patient nursing care needs. The study included not only actual staffing values but measured the variance between actual to required staffing levels and the effect this had on the patient outcomes.

Population, Sample, Setting, and Year: Six New Jersey (United States) healthcare organizations’ comprehensive staffing and patient outcome data were analyzed for three months within the 2002 calendar year.

Variables: Staffing measures derived from a standardized resource management methodology including levels, skill mix, ratio of staffing to patient workload and variance between required and actual direct staffing. Controls included measures of individual patient DRG, acuity and case severity. Outcomes measures included length of stay; mortality; failure to rescue; complications of pressure ulcers; pneumonia; urinary tract infection; and, post surgical complications of thrombosis, pulmonary comprise and infection.

Methods: A statistical model was employed using detailed staffing resources (actual and required) and care environment as the independent variables, individual patient needs as controls and clinical outputs as the dependent variables to demonstrate the relationship between the patient care process and patient outcomes.

Findings: Relationships between staffing inputs, the care delivery process and patient outcomes were quantified.

Conclusions: A detailed and rigorous model comparing patient care inputs and patient care outcomes was able to identify opportunities for care process improvement.

Implications: A transportable, objective methodology has been defined to quantify relationships between patient care inputs and outcomes. The model can identify opportunities for care process improvement in support of evidenced-based nursing.

Back to Outcome Measurement
Back to 15th International Nursing Research Congress
Sigma Theta Tau International
July 22-24, 2004