Nurse Staffing Ratios

What’s new?

  • There were a variety of proposals related to nurse-staffing ratios including HB 2604 during the state’s 2019 legislative session.
  • Nurses, unions, providers, hospitals and others held discussions over the course of the past few months; however there was not enough consensus to move forward.
  • Both the House and Senate have adjourned until October 28 when they will return for a brief veto session to address any actions taken by the Governor and resolve any outstanding issues.

What is the issue?

  • HB 2604, as amended, includes proposals from four different pieces of legislation that would mandate specific nurse staffing ratios.  This opens up a conversation about what staffing levels are necessary for quality patient care and who should be making staffing decisions.
  • The proposal requires rigid nurse-to-patient ratios for various types of patients, with large fines assessed to any hospital that does not follow the specific requirements.
  • Proponents say that the best way to address patient safety is through mandated ratios regardless of hospital size, location or individual needs of patients.
  • Opponents say legislation that mandates specific nurse-to-patient ratios for all hospitals does not provide any flexibility in application. These ratios are arbitrary, focusing only on numbers of patients and RNs, without considering patient needs, staff skills, experience, and desired patient outcomes.

Why does it matter?

  • AMITA Health has a process in place that includes our direct care nurses, to ensure that each clinical unit is appropriately staffed based on the individual patient needs and the skills, training and capabilities of the entire clinical care team under the state’s Nurse Staffing by Patient Acuity requirements.
  • Nurse staffing ratios are unfunded mandates that set requirements for the number of nurses that must be assigned based on the number of patients and their acuity.
  • Rigid, one-size fits all ratio requirements take away flexibility from our direct care-givers to use their clinical expertise to make the best decisions for our patients and practice at the top of their license.
  • Changes to nurse staffing ratios would have a direct impact on how AMITA Health operates.

What is the AMITA Health perspective?

  • Patient and associate safety is a priority for AMITA Health.  Identifying and maintaining appropriate ratios, number and mix, of nursing staff is critical to our high quality care. We currently employ numerous quality checks and safeguards to assure that every patient receives the right care at the right time by the right member of the clinical care team. We hold ourselves accountable and report regularly to the state on patient outcomes.
  • We respect our associates.  AMITA Health recognizes that nurses at times face workflow issues and we strive to be partners to find solutions when that occurs. AMITA Health uses dynamic quality and patient safety programs aimed at facilitating robust staff teams and learning environments to identify near misses, adverse events, including medication errors, and unsafe processes to prevent the occurrence of any future event.
  • AMITA Health innovates to provide support to our associates. AMITA Health works with our nursing staff to identify opportunities to deploy technology and other services such as telehealth to increase quality and safety. At our own cost, these programs are additive to the existing nursing staff and does not replace bedside care. For example, AMITA Health’s tele-ICU program decreased ICU rate of mortality from severe sepsis by 38% in 2017.
  • Unnecessary mandates increase costs without achieving patient safety. Proposals mandating ratios don’t acknowledge the expertise of our nurses and a collaborative work environment. This impacts our ability to have our nurses practicing at the top of their license rather than expanding their responsibilities to include lower level, critical care work currently provided by patient care technicians, transport and lab technicians. Only California has mandated ratios and there has been no systemic improvement in patient outcomes as a result.

Featured News

Featured news includes articles and tweets from multiple viewpoints and is designed to keep you abreast of the current debate around issues that are important to AMITA Health. This information should not be construed as our point of view.

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‘What is a life worth?’ Nurses, hospitals prepare for showdown in Springfield over nurse-patient ratio proposal.

Ahead of state legislators’ return to Springfield next week, supporters of controversial legislation that would mandate patient-nurse staffing ratios in all hospitals in Illinois are touting a ...

Chicago Tribune + April 25, 2019 + View Article

Guest View: Nurse-to-patient ratios would be detrimental for patients

The devil is always in the details.  On the surface, a proposal to mandate rigid nurse-to-patient ratios in Illinois hospitals sounds like a good thing. ...

State Journal Register + April 09, 2019 + View Article