Defining the impact of high patient/staff ratios on dialysis social workers

In the beginning of 2003, the renal provider in Connecticut with the largest market share systematically reduced the hours of social workers and dietitians throughout its units. This change was part of a larger strategy of "leveraging and maximizing... organizational and management structure to improve patient, employee, and business care, including increased management emphasis on improving return on invested capital." For social workers in this company, the target ratio appeared to be 160 patients per 1 full-time equivalent. Soon after this increase in case ratio, the Connecticut Council of Nephrology Social Workers (CT CNSW) became concerned about the reduced level of social work services available to patients.