Risk-Adjusted Staffing to Improve Patient Value

Area of Science:

• Healthcare Management
• Patient Safety
• Nursing Informatics

Background:

• Hospital-acquired conditions (HACs) and infections indicate patient safety issues.
• These adverse events negatively impact patient quality of life and incur significant hospital costs.
• Proactive risk assessment is crucial for improving patient outcomes and hospital efficiency.

Purpose of the Study:

• To introduce the Patient Risk Assessment Profile (PRAP) tool for proactive patient risk assessment.
• To guide nursing staffing and patient assignments on an inpatient surgical unit.
• To enhance patient value, reduce adverse events, and minimize unnecessary hospital costs.

Main Methods:

• Nurses utilized unit-level data to develop and implement the PRAP tool.
• The tool informed staffing decisions and nurse-patient assignments.
• Patient risk was proactively assessed to prevent adverse events.

Main Results:

• Significant decreases in adverse event rates, including patient falls, catheter-acquired urinary tract infections, and central line-associated bloodstream infections.
• Reduced prevalence of pressure ulcers.
• Lowered end-of-shift overtime hours and patient cost per case.

Conclusions:

• The Patient Risk Assessment Profile is an effective tool for improving patient safety and reducing HACs.
• Proactive risk assessment by nurses leads to better patient outcomes and operational efficiency.
• The intervention demonstrated a positive impact on hospital financial performance.