While six states and the District of Columbia are considering legislating mandated nurse staffing levels to deal with patient influxes, Eugene Livtak, president of the Institute for Healthcare Optimization and adjunct professor at the Cambridge, Mass.-based Harvard School of Public Health, thinks there's a better way: regulating inpatient admission.
Dr. Livtak, who discussed his view in a Wall Street Journal op-ed, notes many hospitals suffer from perceived increases in demand on certain days of the week. He argues that this demand is artificial. Rather than being a product of differential emergency department volumes, it is created by scheduling too many inpatient admissions on the same day, thus creating a situation in which hospitals haven't planned for all patients they should be expecting.
Dr. Livtak suggests hospitals consider already scheduled admissions as a factor in scheduling admissions of additional patients with planned procedures.
Understanding the relative constancy in emergency department volumes and overlaying a consistent, rather than sporadic, influx of patients into beds can save hospitals significant sums of money. He cites the case of Cincinnati Children's Hospital, which saved $100 million through one year of streamlining inpatient admissions. Hospitals in a New Jersey project have had similar results, shortening patient stays, reducing rates of hospital-acquired infections, slashing mortality rates and improving nurse staffing ratios as a result.
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