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Boston Globe says no to staffing ratios

The question of whether to impose mandatory nurse staffing ratios is on the ballot in neighboring Massachusetts.

As HANYS has stated repeatedly, experienced clinical leaders should determine staffing levels in clinical settings – not government. Interfering with these critical patient care decisions via a “one-size-fits all” mandatory staffing ratios can be risky, costly and unwise. The Boston Globe agrees.*

Rigid staffing ratios set by state government, the Globe said, “would alter the makeup of clinical teams, leading to more registered nurses – and relatively fewer of everyone else.”

The newspaper asked a critical question: “Would mandated staffing ratios improve the quality of care?” They determined that the answer was no and reasoned: “California, currently the only state with a nursing staffing ratio law, shows how changing the staff mix doesn’t necessarily lead to overall quality improvements. Academic researchers haven’t found evidence (in California) … of systematic improvements in patient outcomes.”

The newspaper warned that, in addition to disrupting care delivery teams, mandatory nurse staffing ratios would create a costly ripple effect throughout the healthcare system. Hospitals facing the ratios mandate would likely hire away nurses from other lower-paying jobs. This ripple effect would increase costs for hospitals and exacerbate workforce shortages for nursing homes, behavioral health institutions and other providers.

The newspaper concluded: “There’s not enough evidence that making hospitals hire more registered nurses would further the overarching goals of access, affordability and quality, and too many reasons to fear it might backfire on all three.”

In short, government-mandated nurse ratios take healthcare backward. The Boston Globe gets it. We hope Massachusetts voters do too.

* See the Boston Globe editorial and the Massachusetts Health Policy Commission study it references.