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Rice Hospital in Willmar, Minn., mounts opposition to legislative efforts that could result in mandated nurse-to-patient ratios

A bad public policy Is how Rice Hospital’s CEO describes legislative efforts that may result in mandated nurse-to-patient ratios. The change may cost the hospital thousands of dollars. Tribune photo/

WILLMAR — Look for Minnesota hospitals to mount vigorous opposition to legislative efforts that could result in mandated nurse-to-patient ratios.

“Bad public policy” was the reaction Wednesday of Michael Schramm, chief executive of Rice Memorial Hospital.

“It hasn’t been demonstrated to improve quality. It’s only been demonstrated to drive up costs,” he said. “We believe that those decisions need to be made at the local level.”

The version of the bill being introduced this session doesn’t contain specific numbers or ratios; those would be determined later by a special committee. But based on the ratios in a similar and unsuccessful bill last year, the cost to Rice Hospital would likely be in the hundreds of thousands of dollars, Schramm said.

The cost of maintaining mandatory nurse staffing levels while allowing 15-minute breaks on each nursing shift alone could amount to upwards of $400,000, he said.

More nurses also would have to be hired to ensure the ratios are continuously met, Schramm said.

Higher costs “would not make sense at a time when we’re trying to be more efficient and hold down health care costs,” he said.

If hospitals are required to spend more in order to fulfill mandatory staffing ratios, the cost “in essence will be passed on to people with health insurance and/or businesses,” Schramm said. “Financially it would be devastating for hospitals across the state if this were put into place.”

The battle over nurse-to-patient ratios has been brewing for months. Nurses say staff ratios must be mandated to ensure they can provide safe, quality care to their patients.

Studies have found that when hospitals have adequate nurse staffing levels, patient outcomes are likely to be better, especially for nursing-sensitive measures such as prevention of pressure ulcers. But researchers have yet to pin down what the optimal nurse-to-patient ratio should be, and some studies have suggested the practice environment is at least as important as staffing levels in contributing to better patient outcomes and job satisfaction among nurses.

Quality care is a priority for hospitals, Schramm said. “We are very much an advocate for providing good, safe patient care and staffing accordingly.”

But the hospital industry contends hospitals should be allowed the flexibility to meet their own staffing needs without mandatory ratios.

California is the only state so far to adopt mandatory nurse staffing levels at its hospitals. Several other states besides Minnesota are considering legislation.

Local hospital officials spoke with their legislators at length about the issue before the start of the 2013 legislative session.

Those efforts, along with public education, will continue, Schramm said. “Talking about the issues, I think, is going to be important. We’re going to have to continue to ratchet up our efforts to communicate with our communities about what this means.”

Anne Polta

Anne Polta covers health care, business/economic development and general assignment. Her HealthBeat blog can be found at Follow her on Twitter at @AnnePolta.

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