Hospitals that operate at or over their capacity may be at increased risk of adverse events that injure patients, according to a study led by investigators from Massachusetts General Hospital (MGH) and Brigham and Woman's Hospital (BWH).
The report in the May issue of the journal Medical Care suggests that efforts to meet two primary challenges facing hospitals today - reducing costs and improving patient safety - may work against each other.
"While financial and political pressures to make health care more efficient are leading to increased hospital occupancy and greater patient turnover, patients and policymakers are quite rightly demanding that health delivery systems be made safer," says Joel Weissman, PhD, of the MGH Institute of Health Policy, the report's lead author. "Our study suggests that pushing efficiency efforts to their limits could be a double-edged sword that may jeopardize patient safety."
In order to examine their hypothesis that increased workload could raise the likelihood of adverse events, the investigators examined data from four hospitals in two states , two large urban teaching hospitals and two suburban teaching hospitals , over the 12 months from October 2000 through September 2001. To compile patient care information they reviewed patient charts and billing records on almost 25,000 patients, selecting 6,841 for comprehensive review, and analyzed that data against information on hospital workloads and staffing patterns, with a focus on variations within each hospital.