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Melissa Bader, Temporary Staffing and Marketing Coordinator, Avera Education & Staffing Solutions 

Bottom Line vs. Patient Care

How Staffing Impacts Profitability

How do you decide between fiscal responsibility, quality of care for your patients and residents and employee satisfaction? Using temporary staffing in your facility while working with a tight budget and maintaining high patient employee and satisfaction scores might seem like a pipe dream; however, there is mounting evidence that links appropriate staffing levels to several key factors that can impact profitability.

Quality of care

Under staffing can have a direct negative impact on the quality of care for your patients and residents. Bringing in quality, experienced temporary staff who are able to step in right away without lengthy training or orientation can help maintain staff to patient/resident ratios as well as ease the burden of your permanent staff. A common myth regarding temporary health care staff is that they are less educated and less competent than those permanently employed by a facility. In fact, most temporary staff have more than 8 years of health care experience and undergo rigorous reference and background checks. Temporary staff receive ongoing education to meet the mandatory requirements of a combination of several health care facility regulatory agencies, including Department of Health, Joint Commission and OSHA.

Preventing costly patient errors

Staffing shortages can result in less time spent with patients, resulting in a higher chance of adverse outcomes. Primary caregivers can help prevent infections, pressure ulcers, falls and other errors that impact patient outcomes.

A study published in Nursing Research found that all adverse events studied (pneumonia, pressure ulcers, infections, patient falls/injuries, sepsis and adverse drug events) were associated with increased costs. A study in Health Affairs found that increased nurse staffing resulted in decreases in adverse outcomes, hospital days, number of patient deaths and cost. Adequate staff to patient/resident ratios can have a significant impact on the key metrics that drive reimbursement rates for pay for performance programs that focus on clinical quality and patient satisfaction.

Permanent staff satisfaction and turnover

Although your permanent staff may be asking to work extra shifts and overtime, keep in mind for the long term that it may not be in your best interests. Heavy workloads have shown to have a negative impact on morale and overall health which in turn can potentially lead to conflict, disruption and turnover.

Consider that 43% of nurses suffering from burnout leave their jobs within a year; estimates show that costs can approach $70,000 per nurse turned when considering personnel expenses and the impact of turnover on productivity and quality. Other studies have shown that temporary staffing helps reduce burnout for permanent staff, which can lower turnover rates.

Changes in census and staffing levels (planned or unplanned)

When facilities eperience fluctuations in census or undergo an expansion or computer conversion, temporary staffing can be a cost-effective solution to maintain staffing levels. It helps avoid the costs of overstaffing during the rest of the year, understaffing during peak periods (which can lead to diverted patients or residents and increased errors), and excessive overtime, which can overburden staff and lower the quality of patient and resident care.

Facility leaders should expect their staffing agency to support their efforts in providing quality care and reaching their patient/resident satisfaction and financial goals. At Avera Education & Staffing Solutions, our staffing coordinators work with you to gain an understanding of your goals and how we can best meet those goals. For more information on developing solutions to your staffing challenges, contact us at (605)668-8475.

Shaffer, Frankling A, EdD, RN, FAAN. Staffing Alternatives Research versus Perception. Nursing Leader. 2006;6:48-53.
Faller, Marcia R, RN, BSN. Travel Nurse Staffing: Quality Staff Equals Quality Outcomes. Cited September 7, 2011.