Doctor And Nursing Shortage Could Undermine Health Care Reform

Yesterday, Kaiser Health News published a report based on two articles, which discusses how the nurse and physician shortage could impact health care reform. Reuters has reported that analysis of the current and projected shortages could have a negative impact should President Obama succeed in his efforts to reform health care. If most of the 46 million currently uninsured Americans enter the health care system, experts fear that there are not enough resources to accommodate them. To address similar concerns, Texas Health Resources Inc., the largest hospital system in North Texas, has formed a temp agency in an attempt to save money and correct its nursing shortage, as reported by the Dallas Morning News.

INQRI teams are on the front line, examining this important issue. Several of our grantees have focused on the impact of nurse staffing, including the use of supplemental nurses, on the quality of patient care, including:

• Ying Xue and Deborah Freund have conducted a project to understand the use of supplemental registered nurses (SRNs) hired from agencies to compensate for hospitals' nurse shortages. The project, "Quality and Cost Outcomes of Hospital Supplemental Nurse Staffing," examines the impact of SRNs on the quality of care and cost.

• In their study, "Nursing Care Quality in Acute Care Hospitals: New Linkages to Patient Outcomes," Arlyss Anderson Rothman and Adams Dudley have examined whether increases in nurse staffing and skill mix improve hospital performance and improve overall nursing performance as measured by composite indicators that capture patients' perceptions of care and other selected outcomes of care such as complication rates.

• In their project, "Quality Care on Acute Inpatient Units," Mary Blegen and Tom Vaughn have examined the power of the National Quality Forum-endorsed measures to advance quality nursing research and design, test other measures as potential indicators of nursing quality, and determine the impact of nurse staffing on these indicators in specific types of patient care units.