ABSTRACT
BACKGROUND: Health systems have long been interested in the best practices for staffing in the acute care setting. Studies on staffing often focus on registered nurses and nurse-to-patient staffing ratios. There were fewer studies on the relationship between interprofessional team members or contextual factors such as hospital and community characteristics and patient outcomes. This qualitative study aimed to refine an explanatory model by soliciting hospital personnel feedback on staffing and patient outcomes. METHODS: We conducted a qualitative study using semi-structured interviews and thematic analysis to understand hospital personnel's perspectives and experiences of factors that affect acute care inpatient outcomes. Interviews were conducted in 2022 with 38 hospital personnel representing 19 hospitals across Washington state in the United States of America. RESULTS: Findings support a model of characteristics impacting patient outcomes to include the complex and interconnected relationships between community, hospital, patient, and staffing characteristics. Within the model, patient characteristics were positioned into hospital characteristics, and in turn these were positioned within community characteristics to highlight the importance of setting and context when evaluating outcomes. Together, these factors influenced both staff characteristics and patient outcomes, but these two categories also share a direct relationship. CONCLUSION: Findings can be applied to hospitals and health systems in a variety of contexts to examine how external factors such as community resource availability impact care delivery. Future research should expand on this work with specific attention to how staffing changes and interprofessional team composition can improve patient outcomes.
Subject(s)
Personnel Staffing and Scheduling , Qualitative Research , Humans , Washington , Personnel, Hospital/psychology , Interviews as Topic , Attitude of Health Personnel , Outcome Assessment, Health Care , Female , MaleABSTRACT
Background: Health systems have long been interested in the best practices for staffing in the acute care setting. Studies on staffing often focus on registered nurses and nurse-to-patient staffing ratios. There are fewer studies on the relationship between interprofessional team members or contextual factors such as hospital and community characteristics and patient outcomes. This qualitative study aimed to refine a causal model by soliciting hospital stakeholder feedback on staffing and patient outcomes. Methods: We conducted a qualitative study using semi-structured interviews and thematic analysis to understand hospital stakeholder perspectives and their experiences of factors that affect acute care inpatient outcomes. Interviews were conducted in 2022 with 38 hospital stakeholders representing 19 hospitals across Washington State. Results: Findings support a model of characteristics impacting patient outcomes to include the complex and interconnected relationships between community, hospital, patient, and staffing characteristics. Within the model, patient characteristics are nested into hospital characteristics, and in turn these were nested within community characteristics to highlight the importance of setting and context when evaluating outcomes. Together, these factors influenced both staff characteristics and patient outcomes, while these two categories also share a direct relationship. Conclusion: Findings can be applied to hospitals and health systems across the globe to examine how external factors such as community resource availability impact care delivery. Future research should expand on this work with specific attention to how staffing changes and interprofessional team composition can improve patient outcomes.