Presenting statistical results
nteasley
MHA-FPX5017_HillTamara_4.1-Presentation1.pptxPresenting Statistical Results for Decision Making
Tamara Hill
School of Nursing and Health Sciences, Capella University
MHA-FPX5017 – Data Analysis for Health Care Decisions
Madeline Meyer
April 2023
Welcome to my presentation for Assessment 4!
Question: How to Decrease Hospital Acquired Conditions?
Content:
Introduction
Purpose of the Study
Results
Recommendations for St Anthony Medical Center
The question we want to answer with this study is how do we decrease hospital acquired conditions (HACs) at St. Anthony Medical Center using the data provided?
We will start with a brief review, discuss the purpose of the study, review the results and then move into the recommendations for decreasing HACs.
Introduction
How do HAC’s effect length of stay (ALOS)?
How do Staffing Levels and Skill mixes of nursing staff statistically effect HACs?
In order to answer the question of how to decrease HAC’s we must start with two questions: 1) How do Staffing Levels and Skill mixes of nursing staff statistically effect HACs? 2) How do HAC’s effect length of stay (ALOS)? The board of St. Anthony Medical Center has noticed an increase in the hospital-acquired conditions (HACs) and is interested in the relation of the current HAC levels to staffing levels and skill mixes of registered nurses (RN) and licensed practical nurses (LPN) as well as the effect of HACs on length of patient hospital stay (ALOS).
Purpose
Reduce the HAC rate = 117.16/1000 discharges
10,000 Discharges last year
$5700 penalty/HAC
Total Cost: $6,678,120
Avg. Cost of additional nursing staff: $72,000
The purpose of the study is to determine how to reduce the HACs, which cost the hospital $6,678,120 last year. We will look at the correlation between staffing levels and skill mixes of nurses and HAC levels to determine which variables are statistically significant to the HAC rate so the hospital understand which variables it has control over. With an initial correlation statistic we can see that HAC rate has a strong negative linear correlation with nurse staffing levels per patient day essentially indicating with an increase in Nursing HPPD (staffing level) there is a decrease in HAC rate and vice versa, but further statistical data will provide us with a more in depth analysis.
Results: HAC rate and Nursing HPPD/Skill Mix
p<0.05 = statistically significant
Dependent Variable: HAC rate
| Independent Variables | P-value |
| Nursing_HPPD | 2.1004E-20 |
| Skill_Mix | 0.246792365 |
A multiple linear regression was used to determine whether nursing HPPD and skill mix has a strong impact on HAC rate. The reports show that the p-value of Nursing HPPD is 2.1E-21 which is very small indicating a statistically significant relationship between Nursing HPPD and HAC rate. Alternatively, the p-value of Skill mix is 0.25 which is greater than 0.05 indicating Skill mix is not statistically significant to HAC rate.
Results: ALOS and HAC Rate
p<0.05 = statistically significant
Dependent Variable: ALOS
| Independent Variable | P-value |
| HAC_Rate | 2.60411E-05 |
A single linear regression was used to determine whether HAC rate has a strong impact on ALOS. The reports show that the p-value of HAC rate is 2.60E-05 indicating HAC rate is statistically significant to ALOS.
Recommendations for reducing HAC rate
An increase in nurse staff hours/patient day to the maximum of the data set (6.71) = $660,630
Implement mandated minimum staffing level
Provide payment incentives based on nurse patient ratio and work environment quality
Hospital-acquired infections (HAI) occur 30% less in the hospitals with the best nurse staffing levels (Aiken et al., 2018)
As the data has shown, Nursing HPPD is statistically significant to HAC rate and HAC rate is statistically significant to ALOS so what does that mean? As Nursing HPPD represents the number of nursing staff hours per patient day, if the hospital increases this value, it can reduce the number of HAC’s per discharge. Evidence based research suggests that improvements to nurse staffing are related to certain quality improvements within a hospital to include patient safety, mortality and failure to rescue (McHugh, Berez & Small, 2013). In fact, Hospital-acquired conditions occur 30% less in the hospitals with the high nurse staffing levels (Aiken, et al., 2018). If St. Anthony Medical Center increases the Nursing HPPD rate to the maximum of the data set (6.71), the hospital can save $660,630 annually which can alternatively pay for the additional nursing staff.
Additional benefit of reducing HAC rate: reduced ALOS
Cost/Inpatient Day: $2600
An additional benefit of reducing HAC rate is a reduction in ALOS which in turn can reduce hospital costs and increase efficiency, however if the ALOS becomes too short, it can alternatively increase readmission and mortality rates (Hamm, Overton, Thomas & Sednew, 2017). With the cost per inpatient day being $2600, a reduction in ALOS can provide cost savings that would provide an avenue for the St. Anthony Medical Center to pay for additional nurses and improve nurse staff levels, whether that be RN’s or LPN’s as the Skill mix is not statistically significant to HAC rate.
Conclusion: Increase Nursing Staff Levels to reduce HAC Rate
An increase in Nursing HPPD is statistically significant to a reduction in HAC rates whereas Skill mix is not. Additionally, a reduction in HAC rates is statistically significant to a reduction in ALOS. Several factors can help with a reduction in HAC rates including minimum nurse to patient ratios, an increase in total nursing staff and compensation for work environment quality. The reduction in HAC rates will help reduce ALOS levels ultimately saving the hospital costs and creating an avenue for paying for the additional nursing staff.
References
Aiken, L. H., Ceron, C., Simonetti, M., Lake, E. T., Galiano, A., Garbarini, A., Soto, P., Bravo, D., Smith, H. L. (2018).
Hospital nurse staffing and patient outcomes. Revista Médica Clinical Las Condes, 29, 322-327.
Hamm, T., Overton, A., Thomas, K. & Rednew, S. (2017). Length of Stay and Its Association With Get With the Guidelines-stroke Award Recognition. Circulation: Cardiovascular Quality and Outcomes 10(3).
McHugh, M. D., Berez, J., & Small, D. S. (2013). Hospitals With Higher Nurse Staffing Had Lower Odds Of Readmissions
Penalties Than Hospitals With Lower Staffing. Health Affairs, 32(10), 1740-7.
