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Toni Talks about PT Today

Unintended Consequences of Cutting Staff

Published September 3, 2013 5:10 PM by Toni Patt

In recent posts, fellow ADVANCE bloggers Dean and Michael have been discussing how companies cut staff as a measure to lower costs. Neither of them supports the idea. Both make valid arguments against the practice that I'm sure would fall on deaf ears. Anyone who works in patient care sees the foolishness of the practice. The facility I'm working in now has cut staff to the bare minimum. Now they are seeing unexpected results.

The obvious result of fewer workers is the rest must pick up the slack. Everyone is given more patients and expected to accomplish everything in the same amount of time. Most of us buckle down and get it done. This doesn't appear to be true of CNAs. They keep quitting. Or they simply stop coming to work. There must be many more CNA jobs than there are CNAs because they keep quitting and we can't replace them.

This means the remaining CNAs must do even more work. So naturally even more of them quit. The staffing matrix places two CNAs on each hall. Now we have two halls per CNA. Needless to say, the response time to call bells is slow. Patient satisfaction continues to fall. Surveys sent out after discharges come back with lower and lower scores. Many patients refuse to come back, even frequent flyer patients, because they're unhappy.

Fewer patients translates into lower census and lower census means decreased revenue on top of already decreased reimbursement. In order to further decrease costs, more staff is eliminated. For some reason, no one makes the connection between inadequate staffing, patient dissatisfaction and lack of return admissions.

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The US actually needs to learn from some mistakes made here in the UK. The Francis Inquiry;

on the horrible state of affairs at the Mid-staffordshire NHS Trust, which met all efficiency targets but neglected patient care, highlights what happens when management is preserved and frontline staff are worked to exhaustion at dangerously low levels. This incident has generated a huge wave of change here in the UK. Lets hope the US learns it before lots of patients suffer the consequences.

Dean Metz September 4, 2013 3:10 PM

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