Hospitals that reduce their size through conscientious work redesign can lower operating costs without harming patient care.
That's the conclusion of a new study by a work redesign consulting firm.
The release of the study feeds a burgeoning debate over hospital restructuring efforts that some affectedHuman resources
groups, primarily nurses, claim is jeopardizing patient safety.
Earlier this month, for example, the American Nurses Association released two reports alleging that hospital "downsizings" hurt patient care because hospitals are eliminating nursing jobs or replacing nurses with lesser-skilled workers (Feb. 13, p. 38).
Prodded by the ANA and other labor organizations, a special national task force authorized by Congress is looking at the link between nurse staffing levels and patient outcomes. However, a final report from the commission isn't due out until early next year, leaving the debate to vested interests representing labor and management.
The latest study was prepared by E.C. Murphy, an Amherst, N.Y.-based healthcare consulting firm. The firm specializes in what it called "data-driven work design," or restructuring based on detailed clinical, operational and job responsibility data.
The study is based on an analysis of 117 hospitals that recently underwent restructuring projects to reduce costs. Some 23 hospitals restructured based on a data-driven work design plan. The others restructured based on less detailed downsizing plans, such as across-the-board job cuts.
The analysis found that hospitals that downsized according to a design plan reduced costs and improved quality more than than hospitals that downsized without one (See chart).
The new study is a follow-up to a study released last fall by E.C. Murphy, which found that hospitals that made substantial across-the-board job cuts are more likely to suffer increases in patient mortality.
The company is working on a third study that will examine the link between the skill mix of a hospital's bedside caregivers and patient outcomes. The study is expected to be released in late spring.