CALIFORNIA: THE FACTS
…not so fast
CALIFORNIA AND STAFFING RATIOS
In 2004, California became the first and only state to experiment with minimum nurse staffing ratios in hospitals. Similar laws have been proposed in numerous other states since, but have been rejected each time. There is no evidence that these ratios have improved quality of care for patients.
QUESTION 1 RATIOS – MORE RIGID THAN CALIFORNIA RATIOS
- California had five years to implement nurse staffing ratios, while Massachusetts hospitals will have only 37 business days to comply.
- Question 1 ratios are more rigid than California ratios and do not factor in other care team members.
- Since implementing ratios, California has continually ranked lower than Massachusetts in nearly all measures of patient care.
- ED wait times have skyrocketed as a direct result of hospitals having to fulfill mandatory ratios.
- California’s ratio law does not carry the hefty fines included in Question 1, which would limit the resources our hospitals can devote to quality care and community services.
RESEARCH DOES NOT SUPPORT QUESTION 1
To date, findings have shown that in California, nurse staffing ratios have resulted in little to no benefits to patient quality and safety, decreased RN job satisfaction, and increased hospital costs.
NO EVIDENCE OF IMPROVED CARE
- “The findings from the majority of these studies do not support the assumption that increases in nurse staffing would lead to better quality of care, improvements in patient safety, or increased patient satisfaction.” – Journal of Nursing Administration, 2013
- “So far, the studies on the situation in California do not support the primary position of the pro- ratio movement, that ratios will improve quality.” – Nursing Economics, 2010
LOSS OF AUTONOMY & FLEXIBILITY
- “Nurse staffing models that facilitate shift-to- shift decisions on the basis of an alignment of staffing with patients’ needs and the census are an important component of the delivery of care.” – New England Journal of Medicine, 2011
- “The combination of meal break and staffing regulations was perceived as reducing the ability of staff nurses to use their professional judgment in determining the best time to take a break, and interviewees believed that nurses found this loss of autonomy frustrating.” – California HealthCare Foundation, 2009
LOWER JOB SATISFACTION
- “Passage of this [California] legislation led to changes in nurse staffing levels; RN workloads increased and RN job satisfaction decreased.” – MEDSURG Nursing, 2011
MASSACHUSETTS VS. CALIFORNIA
Massachusetts hospitals already equal or exceed California hospitals in nearly every meaningful measure of patient care. If mandated staffing ratios actually resulted in higher quality care and safety ratings, then California, not Massachusetts, should have top marks.
The data are very clear. In fact, 24 states without mandated ratios deliver safer patient care than California.
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This piece was written and authorized by registered nurses. Paid for by the Coalition to Protect Patient Safety. Top Contributors: Organization of Nurse Leaders and Massachusetts Health & Hospital Association. For more information regarding contributors, go to www.ocpf.us