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Stress on the ward: evidence of safety tipping points in hospitals.

Kuntz L, Mennicken R, Scholtes S. Stress on the Ward: Evidence of Safety Tipping Points in Hospitals. Manage Sci. 2014;61(4). doi:10.1287/mnsc.2014.1917.

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April 22, 2015
Kuntz L, Mennicken R, Scholtes S. Manage Sci. 2014;61(4).
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Many studies have pointed to a relationship between nurse staffing ratios and patient safety. This retrospective examination of hospital mortality across multiple sites in Germany found that at high hospital volume, mortality increased for six high-risk conditions drawn from AHRQ Quality Indicators—acute myocardial infarction, heart failure, gastrointestinal hemorrhage, hip replacement, pneumonia, and stroke. This study revealed a tipping point, an occupancy rate of approximately 93% capacity, at which hospital mortality increased. The authors theorize that at high occupancy rates, frontline clinical staff are overworked and thus error-prone, consistent with prior studies on patient-to-nurse ratios. They propose flexible staffing policies in order to improve patient safety. A previous AHRQ WebM&M commentary discusses nurse staffing ratios, including challenges related to costs and and best practices for managing staffing needs.

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Kuntz L, Mennicken R, Scholtes S. Stress on the Ward: Evidence of Safety Tipping Points in Hospitals. Manage Sci. 2014;61(4). doi:10.1287/mnsc.2014.1917.