ASSESS 3-6008

1

Assessment 2

Student’s name: Ailetty Guerra Gonzalez

Instructor: Vanessa Trebelhorn

Course: Econ Decision Making Healthcare

Date: May 14, 2026

Systematic Evaluation of Emergency Department

Overcrowding as a Health Care Economic Issue

For this evaluation, I will look at the continuing nursing shortage and the clinical implications of this on health care organizations. Nurses’ shortage contributes to higher operating expenses, staff fatigue/exhaustion, lower quality of health care services for patients, and restricted availability of services to vulnerable communities (Bushra Alshammari et al., 2025). It is clear through a systematic review of a medical-surgical hospital unit that there is a critical need to consider evidence-based strategies to address staffing constraints and organizational change solutions to the problem.

Summary of the Economic Issue and Its Impact

Having a qualified nursing workforce to support every hospital or health care organization on the ground is very critical. With insufficient staff, there can also be communication problems and inefficiencies between colleagues that could result in medical errors and patient safety issues. There are financial pressures for the organization due to overtime working costs, recruitment costs, and the need for agency staff (Pradhan et al., 2024). Furthermore, hospitals with staff changes can also have lower patient satisfaction rates and higher readmissions, which will lead to fewer reimbursement payments and lower organizational profits. Communities are impacted due to fewer employees and, consequently, delays in care, decreased access to care, and decreased health care outcomes, especially in under-resourced communities.

The need to pursue the issue is due to the direct link to patient safety, nurse staffing numbers, and organizational financial performance. Nursing staffing shortages cause economic problems in addition to clinical problems, which negatively impact the provision of health care (Pradhan et al., 2024). The gaps found in the previous assessment were related to the inadequate faculty of nurses, lack of educational material, and lack of strategies to retain the nurse workforce. These vacancies further contribute to staffing inadequacy as there will be fewer skilled members of the nursing workforce.

Socioeconomic and Diversity Disparities

Nursing shortage disproportionately impacts rural, low income, older adult and racial and ethnic minority populations (Thornton & Bowers, 2024). Expanding access to health services, however, relies in part on workers, and in some communities where individuals do not have ready access to hospitals or PCPs, workers must have additional access to services. Recruitment and retention problems in rural hospitals are typically caused by salary, geographical location, and decreased professional development opportunities.

Patient outcome differences are also a factor, and these are also associated with socioeconomic factors. When staff is not in place, it is more likely patients in lower socio-economic status will have delayed treatment, walkout from the emergency department and/or less access to preventive services. Older people with chronic diseases are particularly vulnerable because chronic diseases must be closely monitored and can be complex to manage and care for.

The National Rural Health Association (NRHA) reports that rural communities are still suffering from large nurse staffing gaps to provide high-quality health care and therefore poor health outcomes. Further, a report from the American Association of Colleges of Nursing (AACN) found that minority patients suffer disproportionately due to nursing shortages: In rural minority hospitals (those facilities where health workers can be easily replaced), there is a greater tendency to leave than in other hospitals (Serchen et al., 2025).

Supporting the Need for Change

Research shows that a lack of both nurses and staff across all settings leads to patients dying, medication errors, patient falls, and hospital-acquired infections. Medical centers with more nurses per patient had better results with patient safety and reduced the incidence of preventable complications, according to a study by the Agency for Healthcare Research and Quality (Serchen et al., 2025). Likewise, another study in the Journal of Nursing Administration noted that the impact of nurse burnout and turnover in terms of hiring costs, lost productivity, and lower patient satisfaction is a major cost driver to an organization.

The American Nurses Association (AN) had another study that showed the importance of safe staffing policies in both improving patient outcomes and employee retention. Further evidence indicated that providing stronger nursing education programs in the long term is a viable strategy to address decreasing workforce levels over time by growing the pool of qualified nursing professionals.

Predicted Outcomes

Organizational change that is grounded in evidence should result in improved financial and clinical outcomes because of the nursing shortage. Better staffing numbers can help to alleviate overtime expenses, lower nurse turnover, and limit agency staffing services and their high cost. As a result of having fewer staff turnover, health care organizations will also need less to invest in recruitment and training costs, improving their financial stability. In terms of patient care, more staff is linked to a decrease in medical errors, a shorter hospital stay, fewer readmissions, and higher patient satisfaction scores. Better results can provide reimbursement possibilities for value-based care models, which reward for quality performance metrics. Organizations can benefit from better employee retention, a healthier work culture, and a higher level of trust within their communities that are more trusting of health care services.

In summation, nurses and their respective organizations, patient care systems, and communities continue to suffer from a nursing shortage as an economic problem in health care. A comprehensive analysis of health care facilities proves that understaffed situations lead to higher operating expenses, staff exhaustion, and, related to that, lower patient outcomes. The effects of inequity and diversity are further exacerbated by socioeconomic inequities.

References

Bushra Alshammari, Alsaleh, G. S., Awatif Alrasheeday, Baghdadi, N., Nabat Almalki, Farhan Alshammari, Assiry, A., & Mawahib Almalki. (2025). Association Between Missed Nursing Care and Nurse Fatigue: A Cross-Sectional Correlational Study. Nursing Reports, 15(8), 298–298. https://doi.org/10.3390/nursrep15080298

Pradhan, R., Beauvais, B., Ramamonjiarivelo, Z., Dolezel, D., Wood, D., & Shanmugam, R. (2024). Agency Staffing and Hospital Financial Performance: Insights and Implications. Journal of Healthcare Leadership, Volume 16, 365–374. https://doi.org/10.2147/jhl.s470175

Serchen, J., Johnson, D., Cline, K., Hilden, D., Algase, L. F., Silberger, J. R., Watkins, C., Hilden, D., Silberger, J. R., Beachy, M. W., Carr, P. W., Carney, J. K., Jumper, C. A., Mascarenhas, S. J., Newby, C., Oslock, A., Papadimitriou, A., Radhakrishnan, P., Slocum, J., & Tan, M. J. (2025). Improving health and health care in rural communities: A position paper from the american college of physicians. Annals of Internal Medicine, 178(5). https://doi.org/10.7326/annals-24-03577

Thornton, M., & Bowers, K. (2024). Poverty in Older Adulthood: A Health and Social Crisis. Online Journal of Issues in Nursing, 29(1). https://doi.org/10.3912/ojin.vol29no01man03