JHM: Declining profits, staff reductions could hurt quality of care
Declining profits and decreasing staffing may hinder hospital quality and safety, according to an analysis in the June issue of Journal of Hospital Medicine.
“For generations, American hospitals have been considered recession-proof, but there is reason to believe the current economic crisis is an exception,” stated Jeremy B. Sussman, MD, an internal medicine physician in the division of general medicine at University of Michigan in Ann Arbor, and colleagues.
According to the researchers, hospitals are reporting declining profits, likely because Americans are losing health insurance as they lose jobs. As a result, hospital plans for renovation and new construction are being scrapped, and hospitals are being forced to reduce hospital staff.
“We were surprised by how well hospitals have done during recessions in the last several decades and how, despite the economy in the last 12 months, relatively few hospitals are closing down. Instead, hospitals seem to be dealing with the economic crisis by reducing staff, scaling back or completely stopping new construction projects and implementing various efforts to improve efficiencies of care,” said Sussman.
The authors speculated hospital cutbacks may risk the quality and safety of healthcare delivery, urging the federal government to improve public awareness of overcrowding emergency services, nurse-to-patient ratios and use of IT.
The federal government, the authors suggested, should focus on connecting hospital safety with financial stability. “For example, a hospital could receive government stimulus funds to employ nurse discharge advocates – who educate and prepare patients for discharge with instructions for medications and follow-up – to reduce rehospitalization ... in hopes to preserve employment while advancing patient safety," the authors wrote.
They also encouraged the federal government to increase public awareness of local medical needs, hospital financial stability and available patient services.
“Our primary concern is that hospitals are making decisions to hold off on improvements in infrastructure and technology and cut staffing in ways that lead to a decrease in quality of care,” Sussman said. Cuts to hospital staffing can hurt interactions between healthcare providers and patients, threatening robust nurse-to-patient ratios, which have been shown to affect patient safety, he added.
“The severe recession has adversely affected many hospitals' finances, creating a risk of closure and constraining plans for expansion,” the authors concluded. “We believe there is also a risk of harming clinical quality through decreased staffing that may limit the momentum of the hospital quality movement, especially in fiscally vulnerable institutions.”
“For generations, American hospitals have been considered recession-proof, but there is reason to believe the current economic crisis is an exception,” stated Jeremy B. Sussman, MD, an internal medicine physician in the division of general medicine at University of Michigan in Ann Arbor, and colleagues.
According to the researchers, hospitals are reporting declining profits, likely because Americans are losing health insurance as they lose jobs. As a result, hospital plans for renovation and new construction are being scrapped, and hospitals are being forced to reduce hospital staff.
“We were surprised by how well hospitals have done during recessions in the last several decades and how, despite the economy in the last 12 months, relatively few hospitals are closing down. Instead, hospitals seem to be dealing with the economic crisis by reducing staff, scaling back or completely stopping new construction projects and implementing various efforts to improve efficiencies of care,” said Sussman.
The authors speculated hospital cutbacks may risk the quality and safety of healthcare delivery, urging the federal government to improve public awareness of overcrowding emergency services, nurse-to-patient ratios and use of IT.
The federal government, the authors suggested, should focus on connecting hospital safety with financial stability. “For example, a hospital could receive government stimulus funds to employ nurse discharge advocates – who educate and prepare patients for discharge with instructions for medications and follow-up – to reduce rehospitalization ... in hopes to preserve employment while advancing patient safety," the authors wrote.
They also encouraged the federal government to increase public awareness of local medical needs, hospital financial stability and available patient services.
“Our primary concern is that hospitals are making decisions to hold off on improvements in infrastructure and technology and cut staffing in ways that lead to a decrease in quality of care,” Sussman said. Cuts to hospital staffing can hurt interactions between healthcare providers and patients, threatening robust nurse-to-patient ratios, which have been shown to affect patient safety, he added.
“The severe recession has adversely affected many hospitals' finances, creating a risk of closure and constraining plans for expansion,” the authors concluded. “We believe there is also a risk of harming clinical quality through decreased staffing that may limit the momentum of the hospital quality movement, especially in fiscally vulnerable institutions.”