Impact of Nurse Staffing Mandates on Safety-Net Hospitals: Lessons from California
Article first published online: 19 MAR 2012
© 2012 Milbank Memorial Fund
Volume 90, Issue 1, pages 160–186, March 2012
How to Cite
MCHUGH, M. D., BROOKS CARTHON, M., SLOANE, D. M., WU, E., KELLY, L. and AIKEN, L. H. (2012), Impact of Nurse Staffing Mandates on Safety-Net Hospitals: Lessons from California. Milbank Quarterly, 90: 160–186. doi: 10.1111/j.1468-0009.2011.00658.x
- Issue published online: 19 MAR 2012
- Article first published online: 19 MAR 2012
- 2002. Hospital Nurse Staffing and Patient Mortality, Nurse Burnout, and Job Dissatisfaction. JAMA 288(16):1987–93. , , , , and .
- 2010. Implications of the California Nurse Staffing Mandate for Other States. Health Services Research 45(4):904–21. , , , , , , , and .
- American Nurses Association. 2011. Nurse Staffing Plans and Ratios. Available at http://safestaffingsaveslives.org/WhatisANADoing/StateLegislation.aspx (accessed July 6, 2011).
- 2007. Hospital Financial Condition and Operational Decisions Related to the Quality of Hospital Care. Medical Care Research and Review 64(2):148–68. , , , , , , and .
- 2005. An Update on Safety-Net Hospitals: Coping with the Late 1990s and Early 2000s. Health Affairs 24(4):1047–56. , , , and .
- 2006. The Influence of Health Policy and Market Factors on the Hospital Safety Net. Health Services Research 41(4):1159–80. , , , and .
- 1998. Nurse Staffing and Patient Outcomes. Nursing Research 47(1):43–50. , , and .
- 2011. Nurse Staffing Effects on Patient Outcomes: Safety-Net and Non-Safety-Net Hospitals. Medical Care 49(4):406–14. , , , , and .
- 2008. Nurse Staffing Levels: Impact of Organizational Characteristics and Registered Nurse Supply. Health Services Research 43(1, pt. 1):154–73. , , and .
- 1997. What Is the Harm in Imposing Mandatory Hospital Nurse Staffing Regulations Nursing Economics 15(2):66–72.
- 2007. Mandated Nurse Staffing Ratios in California: A Comparison of Staffing and Nursing-Sensitive Outcomes Pre- and Postregulation. Policy, Politics, & Nursing Practice 8(4):238–50. , , , , , , and .
- California Department of Public Health. 2003. Final Statement of Reasons, R-37-01. Available at http://www.cdph.ca.gov/services/DPOPP/regs/Documents/R-37-01_FSOR.pdf (accessed October 25, 2011).
- 2002. Minimum Nurse-to-Patient Ratios in Acute Care Hospitals in California. Health Affairs 21(5):53–64. , , and .
- 2008. Nurse Staffing Ratios: Trends and Policy Implications for Hospitalists and the Safety Net. Journal of Hospital Medicine 3(3):193–99. , , , , and .
- 2010. The Effect of Hospital Nurse Staffing on Patient Health Outcomes: Evidence from California's Minimum Staffing Regulation. Available at http://www.nber.org/papers/w16077 (accessed October 6, 2011). , , , and .
- 2009. The Economic Value of Professional Nursing. Medical Care 47(1):97–104. , , , , and .
- 2010. Impact of California Mandated Acute Care Hospital Nurse Staffing Ratios: A Literature Synthesis. Policy, Politics, & Nursing Practice 11(3):184–201. , and .
- 2005. The Impact of Hospital Nursing Characteristics on 30-Day Mortality. Nursing Research 54(2):74–84. , , , , and .
- 1997. The Evolution of Support for Safety-Net Hospitals. Health Affairs 16(4):30–47. , and .
- 1988. Nurse Staffing, Patient Outcome and Cost. Nursing Management 19(5):34–43. , and .
- 1999. Population Characteristics of Markets of Safety-Net and Non-Safety-Net Hospitals. Journal of Urban Health 76(3):351–70. , and .
- 2001. Are Urban Safety-Net Hospitals Losing Low-Risk Medicaid Maternity Patients Health Services Research 36(1, pt. 1):25–51. , , and .
- 2011. Getting to Universal Coverage with Better Safety-Net Programs for the Uninsured. Journal of Health Politics Policy and Law 36(3):521–26.
- 2010. Nurse Staffing and Quality of Care with Direct Measurement of Inpatient Staffing. Medical Care 48(7):659–63. , and .
- 2002. The Financial Health of California Hospitals: A Looming Crisis. Health Affairs 21(1):118–26. , and .
- 2011. Statewide and National Impact of California's Staffing Law on Pediatric Cardiac Surgery Outcomes. Journal of Nursing Administration 41(5):218–25. , , , , and .
- 2010. Impacts of Market and Organizational Characteristics on Hospital Efficiency and Uncompensated Care. Health Care Management Review 35(1):77–87. , , and .
- 1991. The Choice of Target Populations. Administration & Society 23(3):333–56. , and .
- 2008. The Characteristics and Performance of Hospitals That Care for Elderly Hispanic Americans. Health Affairs (Millwood) 27(2):528–37. , , and .
- 2007. Concentration and Quality of Hospitals That Care for Elderly Black Patients. Archives of Internal Medicine 167(11):1177–82. , , , and .
- 2007. Nursing Staffing and Quality of Patient Care. Rockville , MD : Agency for Healthcare Research and Quality. , , , , and .
- 2011. The Crucial Role of Counties in the Health of Californians: An Overview. Oakland : California HealthCare Foundation.
- 1998. Nurse Staffing Levels and Adverse Events Following Surgery in U.S. Hospitals. Image—The Journal of Nursing Scholarship 30(4):315–21. , and .
- 2002. Hospital Nursing Staff Ratios and Quality of Care. Davis : University of California. , and .
- 2000. America's Health Care Safety Net: Intact but Endangered. Washington , DC : National Academies Press. , and .
- 2007. America's Health Care Safety Net: Revisiting the 2000 IOM Report. Health Affairs 26(5):1490. , and .
- 2006. The Effect of Changes in Hospital Reimbursement on Nurse Staffing Decisions at Safety Net and Nonsafety Net Hospitals. Health Services Research 41(3, pt. 1):701–20. , , , and .
- 2011. Projecting the Impact of the Affordable Care Act on California. Health Affairs (Millwood) 30(1):63. , and .
- 2009. California's Minimum-Nurse-Staffing Legislation and Nurses’ Wages. Health Affairs (Millwood) 28(2):w326–34. , , and .
- 2011. The Patchwork: Health Reform, American Style. Social Science & Medicine 72(2):125–28. , and .
- 2004. The Managed Care Backlash: Did Consumers Vote with Their Feet? Inquiry 41(4):376–90. , , and .
- 1993. Mandate Design and Implementation: Enhancing Implementation Efforts and Shaping Regulatory Styles. Journal of Policy Analysis and Management 12(4):634–63.
- 2003. Nurse Staffing, Quality, and Financial Performance. Journal of Health Care Finance 29(4):54–76. , , and .
- 2009. Understanding the Safety Net: Inpatient Quality of Care Varies Based on How One Defines Safety Net Hospitals. Medical Care Research and Review 66(5):590–605. , , and .
- 2011. Contradicting Fears, California's Nurse-to-Patient Staffing Mandate Did Not Reduce the Skill Level of the Nursing Workforce in Hospitals. Health Affairs (Millwood) 30(7):1299–306. , , , and .
- 2002. Nurse-Staffing Levels and the Quality of Care in Hospitals. New England Journal of Medicine 346(22):1715–22. , , , , and .
- 2006. Nurse Staffing in Hospitals: Is There a Business Case for Quality? Health Affairs 25(1):204–11. , , , , and .
- 2005. Improving Nurse-to-Patient Staffing Ratios as a Cost-Effective Safety Intervention. Medical Care 43(8):785–91. , , , and .
- 1984. Cooperation, Deterrence, and the Ecology of Regulatory Enforcement. Law and Society Review 18(2):179–224.
- 2004. Supply, Demand, and Use of Licensed Practical Nurses. Washington , DC : U.S. Department of Health and Human Services, Health Resources and Services Administration. , , , , and .
- 2006. Longitudinal Analyses of Nurse Staffing and Patient Outcomes: More about Failure to Rescue. Journal of Nursing Administration 36(1):13–21. , , and .
- 2008. Will Mandated Minimum Nurse Staffing Ratios Lead to Better Patient Outcomes? Medical Care 46(6):606–13. , , , and .
- 2004. California's Minimum Nurse-to-Patient Ratios: The First Few Months. Journal of Nursing Administration 34(12):571–78.
- 2008. How Many Nurses per Patient? Measurements of Nurse Staffing in Health Services Research. Health Services Research 43(5):1674–92. , , , and .
- 2000. Minimum Nurse Staffing Ratios in California Acute Care Hospitals. San Francisco : University of California, San Francisco, Center for the Health Professions. , , , , and .
- 2006. Community Approaches to Providing Care for the Uninsured. Health Affairs 25(3):w173–82. , , and .
- 2002. Nursing-Related Determinants of 30-Day Mortality for Hospitalized Patients. Canadian Journal of Nursing Research 33(4):71–88. , , , and .
- 2003. Improving Nurse Staffing Measures: Discharge Day Measurement in “Adjusted Patient Days of Care. Inquiry 40(3):295–304. , , and .
- U.S. Department of Labor, Bureau of Labor Statistics. 2010. Local Area Unemployment Statistics. Available at http://www.bls.gov/lau/home.htm (accessed November 29, 2010).
- 1998. The Dartmouth Atlas of Health Care. Hanover , NH : Center for the Evaluative Clinical Sciences, Dartmouth Medical School. , and .
- 2008. Comparisons of Change in Quality of Care between Safety-Net and Non Safety-Net Hospitals. JAMA 299(18):2180–87. , , and .
- 2001. How Did Safety-Net Hospitals Cope in the 1990s? Health Affairs 20(4):159–68. , , , and .
- 2006. Safety-Net Activities and Hospital Contracting with Managed Care Organizations. Medical Care Research and Review 63(6):90S–111S. , and .
- 2008. Safety-Net Hospitals. Medical Care Research and Review 65(4):478–95. , and .
- 2010. The Relationship between Safety Net Activities and Hospital Financial Performance. BMC Health Services Research 10(15):1–12. , , and .