Overtime: How it may be harming your business and your patients

Healthcare Information Technologies

Learn the impacts of overtime for your business and patients.

Healthcare

Overtime
your business and your patients
How it may be harming

Overtime
50%of full time nurses
work OVERTIME
Source: Bae, Sung-Heui. "Nursing Overtime: Why, How Much, and Under What Working
Conditions?" Nursing Economics, 30, no 2 (March/April 2012): 60-71.

Overtime hours
Full time nurses
work an average
of 7 OVERTIME
hours each week
Source: Health Resources and Services Administration, "The Registered Nurse Population.
September 2010," Accessed July 28, 2014,
http://bhpr.hrsa.gov/healthworkforce/rnsurveys/rnsurveyfinal.pdf

Total Cost of OVERTIME = $12M
Based on a 300 bed hospital
Cost implications
Source: Sage Growth Partners Analysis

Overtime
Potential Savings
Overtime SAVINGS = $1,154,828
Based on 300 bed hospital

Medical errors
Nurses who work OVERTIME are
to make medical errors
3
X
more
likely
Source: Bae, Sung-Heui. Presence of Nurse Mandatory Overtime Regulations and
Nurse And Patient Outcomes. Nursing Economics. March/April 2013; 31, no. 2: 59-
89.

Medical
Errors Overtime
Potential Savings
Overtime SAVINGS = $1,154,828
Medical Error SAVINGS = $663,376
Based on 300 bed hospital

Turnover
Nurses working 12 hour shifts are
2Xmore likely
to intend to
leave their job within 1 year
Source: Stimpfl, Amy, et al. The Longer The Shifts for Hospital Nurses, The Higher
The Levels Of Burnout And Patient Dissatisfaction. Health Affairs, 31, no.11 (2012):
2501:2509.

Turnover
Medical
Errors Overtime
Potential Savings
Overtime SAVINGS = $1,154,828
Medical Error SAVINGS = $663,376
Turnover SAVINGS = $761,405
Based on 300 bed hospital

patients are more likely to rate hospital
6 or lower out of 10 on HCAHPS survey
Patient Satisfaction
Source: Stimpfl, Amy, et al. The Longer The Shifts for Hospital Nurses, The Higher
The Levels Of Burnout And Patient Dissatisfaction. Health Affairs, 31, no.11 (2012):
2501:2509.
when nurses work
13 hours

Value of Patient
Source: Wolf, Jason and Widmer, Thomas. "Return on Service The Financial Impact of the Patient
Experience." 2011
Lifetime Value of
Patient =
$150,000
Lifetime Value of
Household =
$404,000

Turnover
Medical
Errors Overtime
Patient
Satisfaction
Potential Savings
Overtime SAVINGS = $1,154,828
Medical Error SAVINGS = $663,376
Turnover SAVINGS = $761,405
Patient Satisfaction SAVINGS = $793,892
Based on 300 bed hospital

Overtime Schedules
are associated with a
61%Increased
Injury rate
Nurse injuries
Source: Bae, Sung-Heui. "Nursing Overtime: Why, How Much, and Under What Working
Conditions?" Nursing Economics, 30, no 2 (March/April 2012): 60-71.

Turnover
Medical
Errors Overtime
Patient
Satisfaction
Employee
Injuries
Potential Savings
Overtime SAVINGS = $1,154,828
Medical Error SAVINGS = $663,376
Turnover SAVINGS = $761,405
Patient Satisfaction SAVINGS = $793,892
Employee Injuries SAVINGS = $100,841
Based on 300 bed hospital

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Title: The influence of working longer shift on nurses` quality of care Introduction: During the past three years, a series of studies have demonstrated the risks to patients and providers of long work hours in health care. Compared with nurses working shorter hours, nurses working greater than 12.5–13 consecutive hours report (1): a 1.9- to 3.3- fold increased odds of making an error in patient care1,2; (2) a significantly increased risk of suffering a needlestick injury, exposing them to an increased risk of acquiring hepatitis, HIV, or other bloodborne illnesses3; and (3) significant decrease in vigilance on the job. (9) A number of healthcare organizations and state boards of nursing have adopted strategies to address concerns related to nurses’ shift lengths and fatigue and the connection with risks to patients and care providers. In 2003 the Accreditation Council for Graduate Medical Education (ACGME) began limiting shift length and duty hours of residents and fellows (ACGME, 2010), and ACGME published additional limitations in 2011 (ACGME, 2011). The Institute of Medicine (IOM) has also published guidelines and recommendations regarding nurses’ roles in the protection of patient safety and improved patient outcomes (IOM, 2004). (7) Shift work is an inevitable part of many jobs which require 24 hour attendance and comprise working at unusual hours, especially at length shift . Because of potential hazards of length shift work on safety and health, there was an intensive debate on the “best compromise” shift system (Folkard, 1992). Shift length and kind of shift rotation (forward/backward rotation; quick and slow rotation) have been considered at length (Smith, Folkard, Tucker & Macdonald, 1998). Up to now, no unequivocal conclusion can be drawn with respect to shift length. One reason might be that mediating factors play an important role, such as length of recovery intervals between shifts, options for sleep recovery in these intervals, options to cope with fatigue within the shift, or personal and family activities, all of which contribute to cope with work stress (Folkard, 1992; Smith et al., 1998). (32) Extended work shifts of twelve hours or longer are common and even popular with hospital staff nurses, but little is known about how such extended hours affect the care that patients receive or the wellbeing of nurses. Survey data from nurses in four states showed that more than 80 percent of the nurses were satisfied with scheduling practices at their hospital. However, as the proportion of hospital nurses working shifts of more than thirteen hours increased, patients’ dissatisfaction with care increased. Furthermore, nurses working shifts of ten hours or longer were up to two and a half times more likely than nurses working shorter shifts to experience burnout and job dissatisfaction and to intend to leave the job. Extended shifts undermine nurses’ well-being, may result in expensive job turnover, and can negatively affect patien ...

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JOB SATISFATION AND NURSE PATIENT RATIO 24 Table of Contents Chapter 1: Introduction1 Background of the Problem1 Problem Statement1 Purpose of the Study1 Nature of the Study1 Significance of the Study1 Research Questions1 Hypotheses1 Brief Review of the Literature2 Conceptual Framework2 Assumptions, Limitations, and Delimitations2 Definition of Terms3 Conclusion3 Chapter 2: Literature Review4 Historical Development of the Topic4 Contemporary Perspectives4 Historical Development of the Theory4 Importance of the Study and Implication for Practice4 Directions for Future Research5 Summary5 Chapter 3: Research Method6 Research Design6 Appropriateness of Design6 Procedure6 The Role of the Researcher6 Research Questions6 Hypotheses6 Population and Sample6 Geographic or Virtual Location6 Instrumentation6 Data Collection6 Data Analysis7 Human Participants and Ethics Precautions7 Validity and Reliability7 Contribution to Social, Practice, or Organizational Change7 Summary7 Chapter 4: Results8 General Description of the Participants8 Research Questions8 Sample Size8 Pilot Tests8 Data Collection8 Unit of Analysis and Measurement8 Data Analysis8 Coding and Codebook Generation8 Qualitative Results8 Results of Hypothesis Tests9 Between Group Differences9 Outliers9 Validity and Reliability9 Summary9 Chapter 5: Discussion, Conclusions, and Recommendations10 Ethical Dimensions10 Limitations10 Overview of the Population and Sampling Method10 Data Collection and Analysis10 Summary of Findings10 Explanation of Findings10 Recommendations11 Reflecting Upon the Study11 Suggestions for Future Research11 Implications for Social, Practice, or Organizational Change11 Conclusions11 References12 Appendix A: Tables13 Appendix B: Figures15 Table of Tables Table A1: This is an Example APA Table in Appendix A and Uses the APA Table Title Style14 Table of Figures Figure B1. This is an example APA figure using the APA Caption Style. Neo meets the Architect while seeking the Source.16 JOB SATISFATION AND NURSE PATIENT RATIO i Chapter 1: Introduction Fatigue in nurses have been a factor that has always come with very many consequences in the medical world such as poor decision making that has not only led to negligence in the hospital but also inappropriate administration of prescribed medicine leading to, at worst, death of patients. We are to see how nurse’s fatigue relates to job satisfaction and nurse to patient ratio. Background of the Problem Nurses who are dissatisfied in their jobs always lack mental strength or the motivation for that matter to endure the ever-demanding requirements that are accompanied by the nursing career. This lack of interest of interest may make them work without much care in their job which results to dissatisfaction among patients (Chang, Chiu, Lin, & Lee,2009). Nurse to patient ratio has been a major topic of focus among stakeholders of healthcare institutions. An appropriate nurse to patient ratio is required to see that healthca.

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Running head: Analysis of a pertinent healthcare issue 1 Analysis of a pertinent healthcare issue 9TITLE STUDENT SCHOOL As you all know, healthcare is always in high demand. With such a growing demand for healthcare services creates an even greater demand for health providers. Because the populations demand for healthcare is ever-growing and lack of health providers is on the rise, patient care deficits are prevalent. Patient care is not being met because there simply aren't enough providers to provide care for every patient in need. On the other hand, health care providers and organizations are suffering too. The workload is very strenuous on healthcare providers and detrimental to healthcare organizations. In our organization we are affected by this by having an overwhelming demand of patients in our emergency rooms and an underwhelming amount of staff to accommodate these patients. In more detail this affects our organization by causing an increase in nurse burnout, 30-day readmits, and poor patient satisfaction scores to name a few examples. Heavy workload environments along with poor patient to nurse ratios contribute significantly to nurse burn out (Norful, 2018). Because of this, the chances of nurses making medical errors are more likely. As a result, our organization chances of liability for medical errors are increased. If patient care was not provided adequately because of lack of providers, many patients will come back to the hospital within 30 days. When this happens often insurance companies find the hospital responsible and will not pay (Park, 2018). As a result, the hospital is held accountable for lack of care and suffers financial losses. Satisfaction rating by patient often result in greater financial opportunities for our organization. A lot of patient dissatisfaction responses came from their needs not being meet. Things such as time spent with physicians and wait time to be seen are common issues. Now that we know what the issue is what are we going to do about it? Though the lack of healthcare providers is a prominent issue for all healthcare entities it is not a new. For years studies have been conducted to help alleviate this issue. In a study, advanced scheduling was used to alleviate high wait times and overall continuity of patient care (Qu, 2007). The daily health care provider demand was examined along with the patient need to create a schedule that consist of adequate provider to patient ratios. As a result, healthcare providers were not overbooked, and patients had less of a wait time and more time spent with providers. In another study, federal qualified health centers were initiated in order to decrease the shortage of health providers (Xue, 2018). These health centers provided underprivileged communities that did not have access to health care facilities, a place where they could be seen by primary providers. As a result, the demand for healthcare providers decreased in the e.

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PFCH Email Record From: Davis Geach <[email protected]> To: Zachary Hardie Subject: Increase in nursing staff Zach: Caterina has been insisting for some time that we need to hire more nurses. I’ve arranged for her to give a presentation to the Board next month to plead her case. I know that following her presentation, they will want me to advise them of any alternatives. Caterina’s argument is that the nurses are over-worked and that has a negative effect on patient care and also leads to the nurses leaving PFCH for other hospitals. I’m wondering whether giving the nurses a raise might solve the problems. Please put together some numbers to compare hiring more nurses versus giving the nurses a raise. Davis Geach, President/CEO Please consider the environment before printing this email. This message is private and confidential. If you have received it in error, please contact the sender immediately and delete it from your system. PFCH Email Record From: Zachary Hardie <[email protected]> To: Caterina Hossack Subject: Re: Increase in nursing staff Hi Caterina. Mr. Geach asked me to prepare some information for the Board of Directors relating to your proposal to add more nurses to the hospital staff. In order to do this, I need to know the current nursing ratio and what nursing ratio you are proposing. Thanks for your help. Zachary Hardie, Chief Financial Officer Please consider the environment before printing this email. This message is private and confidential. If you have received it in error, please contact the sender immediately and delete it from your system. PFCH Email Record From: Caterina Hossack <[email protected]> To: Zachary Hardie Subject: Re: Increase in nursing staff The hospital currently maintains a 5 to 1 nursing ratio (5 patients for every nurse). I will suggest to the Board of Directors that we move to a 4 to 1 nursing ratio (4 patients per nurse). Will the information that you are preparing address patient care, worker satisfaction and nursing turnover? Caterina Hossack, Chief Nursing Officer Please consider the environment before printing this email. This message is private and confidential. If you have received it in error, please contact the sender immediately and delete it from your system. PATTON – FULLER COMMUNITY HOSPITAL From: Zachary Hardie, CFO To: Davis Geach, President/CEO Re: Increase in nursing staff Per your request, I have prepared a financial analysis comparing the increasing of the nursing staff to the granting of an across the board raise to the existing nursing staff. In order to have a common basis for the comparison, it was necessary to take our existing salary and benefit costs for the nursing staff and show how they related to the existing patient/nurse ratio. I have attached as an exhibit a table that presents our current patient stat.

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The Impact of Burnout syndrome on Nurse Workers !1 The Impact of Burnout Syndrome on Psychosocial Wellbeing, Expected Outcomes, Self-efficacy, Turnover, and Interest in Career of Nurse Workers. Olajumoke Omiyale Aspen University Author Note Essentials of Nursing Research N494 Dr. Keshea Britton Date of Submission February 11, 2020 Burnout Among Nurses !2 Background Burnout is a very common condition across the world and especially in the nursing career. It's the reduction in the energy and zeal of nurses manifesting in form of being emotionally exhausted, lacking motivation, feeling frustrated, fatigued, and low reaction time which reduces individuals' output and work efficacy in general. Burnout has been strongly attributed to the deficit in the number of healthcare professionals, a concern that goes way to be a matter of global importance. The rapidly changing healthcare landscape that brings a paradigm shift to increased demand for healthcare services in the world population has come with its challenges. Although experts associate the change to improvement in the quality of life for which people become capable of seeking healthcare services, the move has placed a lot of pressure on not only the healthcare systems but particularly on the workforce (Mudallal, Othman, & Al Hassan, 2017). However, governments have not moved at a similar pace to address these pressures, leaving the mantle on the health institutions and professionals. To be specific, nurses, as well as other healthcare providers, are left with a large number of patients to takes care of, a number that keeps on increasing day after day, keeping them on the run all the time. The absolute result of this healthcare environment is burning or wearing out, which without doubt minimizes the efficacy of the nurse’s output. The working environment for which the nurse staff doesn't match the care demand culminated by poor leadership creates unattractive working conditions. Indeed, WHO reports indicate that shortages of nurses would nationally and internally interfere with the efforts to health and well being of the world population. Where staff shortage exists, human resources are Burnout Among Nurses !3 overstretched, working conditions become poor and unbearable, work becomes increasingly hazardous to the health of the nurse- they get no rest, become stressed, productivity decrease with the poor patient outcome which add up to the trauma of the workers. They end up losing interest in their job, become highly dissatisfied, burnout and increase the chances of quitting the job. In return, the turnover of nurses affects the quality of healthcare services offered because of a lack of expertise and increasing the workload burden on the remaining staff (Sobral, et. al, 2018). .

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