The top priorities for health care administrators include the
development of strategic plans, the improvement of medical facilities
and systems of patient care, regulatory compliance, and resource
allocation (Buerhaus et al., 2007). Regulatory compliance involves
several organizations, such as the Joint Commission, CMMS, and
OSHA. Health care administrators ensure that their medical centers
run efficiently and safely; however, staffing shortages can have a
substantial negative impact on operations (Buerhaus et al., 2007).
Studies have demonstrated a strong correlation between inadequate
staffing in a medical care setting and an increase in adverse patient
care events, an increase in patient mortality, a reduction in care
capacity, an increase in operating and labor costs, and a decrease in
operational efficiency and positive care outcomes (Buerhaus et al.,
2007). This negative impact of staffing shortages becomes even more
problematic when we talk about federal rulings, such as HIPAA,
HITECH, and ACA.
Successful compliance with HIPAA, the technological and policy
standards of the HITECH Act, and the increased quality standards
mandated by ACA require substantial staffing resources. Reduced
staffing, especially nurses, often results in an operational shift of
patient care to a triage approach in which staff perform only
essential duties and often omit or miss other important care
responsibilities; as a result, the quality of patient care suffers and
adverse events increase, which go against the ACA quality standards
(Blouin & Podjasek, 2019). Another outcome of staff shortages is
fatigue due to longer shift work and higher attrition (Blouin &
Podjasek, 2019). Studies have linked fatigue with higher stress levels
and lower productivity, which are known risk factors of adverse care
events, patient safety incidents, and staff safety incidents (Blouin &
Podjasek, 2019).
The ACA established the Hospital Readmission Reduction Program
that financially penalized hospitals for high readmission rates (Blouin
& Podjasek, 2019). Staffing shortages reduce efforts in teaching,
patient education, and care coordination, which ultimately result in
increased readmission rates and increased hospital operating costs
due to financial penalties under ACA (Blouin & Podjasek, 2019).
Another challenge for health care administrators is the demand for
cost cutting measures, which can often result in pressure to reduce
nursing staff. In reality, the reduction of staff leads to attrition and
higher operating costs due to the recruiting and training of
replacement staff (Blouin & Podjasek, 2019). Adequate staffing will
reduce costs and increase revenue by reducing lengths of stay,
readmissions, and adverse outcomes (Blouin & Podjasek, 2019).
Blouin, A. S., & Podjasek, K. (2019). The continuing saga of nurse
staffing: Historical and emerging challenges. JONA: The Journal of
Nursing Administration, 49(4), 221-227.
Buerhaus, P. I., Donelan, K., Ulrich, B. T., Norman, L., DesRoches, C.,
& Dittus, R. (2007). Impact of the nurse shortage on hospital patient
care: Comparative perspectives. Health affairs, 26(3), 853-862.
