Balancing Interests

Hospitals are in a precarious position secondary to competing goals that drive fundamental practices. How to balance the disparate goals of reducing overall healthcare costs and improve patient safety? The idea that the two goals create tension suggests an underlying thesis; that efforts to improve safety are intrinsically not cost effective.

A study published in the May issues of Medical Care considered outcomes in light of implementation of cost saving strategies, such as increases to the patient-to-nurse ratio. The outcomes of interest that the authors considered were adverse events not attributed to the patient’s medical condition. Findings indicated a 28 percent rise in adverse events attributed to increased nursing burdens alone.

The retrospective study of over 6,500 patient records during a 12 month period documented over 1,500 adverse events.

The authors note that mistakes naturally occur when workload is increased. Simply, when an individual’s responsibilities increase, the likelihood of errors also increases.

The healthcare system is in desperate need of practical and affordable solutions to address the goals described. In fact, the future of the U.S. healthcare system will likely be driven by these two goals.

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