Source: Congressional Budget Office, August 7, 2009
From CBO Director’s Blog:
On Friday CBO released a letter that discusses how the agency’s budget estimates reflect potential reductions in federal costs from improvements in health that might result from expanded governmental support for preventive medical care and wellness services.
Preventive medical care includes services such as cancer screening, cholesterol management, and vaccines. In making its estimates of the budgetary effects of expanded governmental support for such care, CBO takes into account any estimated savings to the government that would result from greater use of preventive care as well as the estimated costs of that additional care. Although different types of preventive care have different effects on spending, the evidence suggests that for most preventive services, expanded utilization leads to higher, not lower, medical spending overall.
That result may seem counterintuitive. For example, many observers point to cases in which a simple medical test, if given early enough, can reveal a condition that is treatable at a fraction of the cost of treating that same illness after it has progressed. But when analyzing the effects of preventive care on total spending for health care, it is important to recognize that doctors do not know beforehand which patients are going to develop costly illnesses. To avert one case of acute illness, it is usually necessary to provide preventive care to many patients, most of whom would not have suffered that illness anyway. Judging the overall effect on medical spending requires analysts to calculate not just the savings from the relatively few individuals who would avoid more expensive treatment later, but also the costs of the many who would make greater use of preventive care.
Source: Quality Partners of Rhode Island, 2009
From a Commonwealth Fund summary:
Based on the experiences of more than 400 nursing homes, the Staff Stability Toolkit is designed to serve as an evidence-based resource for nursing homes that are working to reduce staff turnover. The toolkit, developed by Quality Partners’ of Rhode Island with Commonwealth Fund support, identifies some of the perverse incentives, such as giving hiring bonuses rather than retention bonuses, and poor management practices, such as ineffective hiring and scheduling, that contribute to high staff turnover in nursing homes. It also offers guidance on ways to sustain employee stability.
* Sample Worksheets – Worksheets 1 through 9
* Worksheet 1 – Employment Status
* Worksheet 2 – Current Staff by Length of Service
* Worksheet 3 – Vacancies
* Worksheet 4 – Turnover Rates
* Worksheet 5 – Turnover Replacement Costs
* Worksheet 6 – Terminations by Length of Service
* Worksheet 7 – Absenteeism
* Worksheet 8 – Call-In Log
* Worksheet 9 – Incentives
* Training Analysis
Source: Lynda Olender-Russo, RN, August 1, 2009
Disruptive and uncivil behavior causes workplace tension, absenteeism, psychological problems, and even violence. It can also cost the healthcare system talented nurses–or impair patient care. What steps are leaders in the medical community taking to halt this growing problem?
Source: Randall R. Bovbjerg, Barbara A. Ormond, Nancy M. Pindus, Urban Institute, July 2009
From the abstract:
Nurses are health care’s backbone, spending the most time with patients and adding value within institutional teams of caregivers and in providing ambulatory primary care. Short-term shortages wax and wane as employers seek to hire at accustomed prices. More seriously, the next decade may see more older nurses retiring than new ones entering the workforce, so education needs to be augmented and improved. But no precise estimation method can show how many nurses society “should” produce. Policy should focus more on nurses’ scopes of practice and aligning how they are treated and paid with the value they add to patient care.
Source: Kathleen J. Mullen, Richard G. Frank, & Meredith B. Rosenthal, RAND Working Paper Series No. WR- 680, April 14, 2009
From the abstract:
Despite the popularity of pay-for-performance (P4P) among health policymakers and private insurers as a tool for improving quality of care, there is little empirical basis for its effectiveness. The authors use data from published performance reports of physician medical groups contracting with a large network HMO to compare clinical quality before and after the implementation of P4P, relative to a control group. They consider the effect of P4P on both rewarded and unrewarded dimensions of quality. In the end, they fail to find evidence that a large P4P initiative either resulted in major improvement in quality or notable disruption in care.
Source: Peter I. Buerhaus, David I. Auerbach and Douglas O. Staiger, Health Affairs, Vol. 28 no. 4, July 2009
From the abstract:
In this paper we examine the recession’s impact on current RN employment and on projections of the future size of the nurse workforce. Clarifying the effect of the recession on RN employment can help employers and policymakers anticipate the possibility that the long-standing nurse shortage is finally winding down. But before concluding that it is safe to turn attention away from the nurse workforce, we examine trends in the composition of the RN workforce that lie underneath the recent employment changes. This assessment suggests the need to strengthen the current workforce before the recession lifts and imbalances in the supply and demand for RNs reappear. Next, we focus on the future workforce and project the age and supply of RNs through 2025, noting the impact of the recession on these projections. We conclude with policy implications to support the current nurse workforce and remove barriers that are blocking efforts to expand the long-term supply of RNs.
Source: Marcia Faller, AMN Healthcare, July 22, 2009
In their quest to recruit nurses, healthcare facilities highlight features such as shared governance, reduced overtime and increased efficiencies. Yet there is one area that perhaps should be more heavily promoted in the recruitment efforts: safe staffing levels.
Source: Debra Wood, AMN Healthcare, July 22, 2009
Providing a rewarding environment in which nurses can work, with opportunities to grow, and a chance to be heard and participate in practice decisions keeps experienced nurses at the bedside and, ultimately, improves patient care.
Source: James Fraleigh, RN Magazine, July 2009
For many American workers, the last 2 years have seen a growing storm of stagnant wages, eroding benefits, and feared or actual layoffs. But as recession swamped the economy, the majority of nurses who participated in RN’s biennial earnings survey have enjoyed rising fortunes.
Defying the grim statistics, just over half of our respondents got a raise in the last seven months, with the other half earning one more than seven months ago. On average, raises were 3.2% over their previous wages, which beat or matched 79% of participants’ last increases. Since our 2007 survey, the average annual base pay of salaried nurses (typically in management or administrative positions) grew 10%, or $6,746, to $75,180. Nurses paid by the hour fared even better; their average base earnings rose 13% ($7,460), to $64,018. Combined, nurses received $7,270 more on average, for a 12% raise to an overall base pay of $65,653.
But a few nursing specialties and settings bucked this trend with smaller raises or even declines; hospitals and other medical settings aren’t immune to economic pressures.
Source: Chelsey Ledue, Healthcare Finance News, July 02, 2009
Nurses believe that heavy workloads and insufficient staff are impacting patient care and health outcomes around the world, according to research presented at the International Council of Nurses’ 24th Quadrennial Congress.