No independent organization has yet surveyed Methodist's model to determine if it results in better nursing performance and patient outcomes. And so far, there are no good data on whether having more staff nurses--as opposed to outside help--improves hospital care, says David Hickam, a professor in the department of medicine at Oregon Health and Science University.
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But plenty of research shows that higher staff-to-patient ratios and more attention to nursing care at hospitals decrease medical errors and improve patient care. A University of Pennsylvania study, published last fall in the Journal of the American Medical Association, concluded that patients who have common surgeries in hospitals with the poorest staffing levels have up to a 31 percent greater chance of dying. The researchers, who studied surveys of 10,184 staff registered nurses and the outcomes of 232,342 patients, also found that every extra patient in an average nurse's workload raised a surgical patient's risk of death by 7 percent. And in hospitals where nurses had heavier patient loads, patients with life-threatening complications were more likely to die.
Similarly, a report developed by Hickam and his colleagues at the Oregon Health and Science University, which reviewed 115 studies on the effects of healthcare working conditions on patient safety, found that boosting nurse staffing levels in acute-care hospitals directly benefits patient care and outcomes. The report, released last spring, also found that outcomes improve as the experience level of the healthcare professionals goes up.
To staff nurses like Methodist's Behrmann, the benefits of a stable, experienced nursing staff are self-evident. A system that respects nurses, empowers them and their supervisors, and allows them to form coordinated teams can only help patients, he has come to believe."Even with the best circumstances and best staff, you're going to have some terrible days on a nursing floor," says Behrmann. "You--and the patient, I'm sure--would rather have a terrible day with competent people who you've worked with a lot. I don't mind stress, but I don't like to work scared. I don't work scared here; we know each other."
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