Staffing Challenges In Acute Care Hospitals

Staffing Challenges In Acute Care Hospitals


Nursing is acritical factor in determining the quality of care in the healthcare facilities and the outcome of the patient. There are various concerns on the nature of transformation taking place in the healthcare sector with the issue of staffing being on the forefront as far as the care is concerned. Acute care hospitals which serve in providing short-term treatment for illnesses and other urgent medical conditions has been experiencing the challenge on staffing due to the increased number of medical emergencies.  The delivery of acute care services is by teams of healthcare professional from a range of surgical and medical specialties. It may require urgent care or another stay facility together with the assistance of other diagnostic services which calls for a more qualified team of specialties. The increasing demand for acute care services has seen the increase in staffing challenges that need to be addressed soonest possible to help curb the increasing medical emergencies and health conditions. By solving the staffing issue, it is easy to resolve a stable nursing workforce, quality patient outcome and ultimately deliver strong financial results.

Nurse to Patient Ratio

The ratio of staffs to patients in the acute hospitals is quite alarming with one medical practitioner having to attend to a large number of patients at a given time. According to McHugh, Berez& Small (2013), the imbalances in a number of staffs has major impacts on the quality of care provided, patient dissatisfaction, higher readmissions and other medical referrals and critical events. The quality of care is determined by the process of care which involve what is done to, with, and for the patient. The process of care pertain all the critical procedures and services that a qualified personnel offers to the patients. It also includes the interpersonal attitude and skills for instance compassion and flawless communication skills from the health care providers.

In the acute care hospitals, the outcome of care which is the end results of the healthcare in terms of healing and functioning of the patient’s body include various indicators such as readmissions, death rates, illness rates as well as the physiological measures which are the most critical measures by the medical practitioners. The health outcomes more broadly encompass functional abilities, discomfort and pain and mental and emotional wellbeing of the patients and their families. In the current acute hospitals, there is a notable importance placed on the quality of care as well as the wellbeing of the patients and the staff. It is noted that there is an inadequate staffing in the acute care hospitalsand a minimum nurse to patient ratio is important as it yields more benefits both to the patients and nurses. A minimum nurse to patient ratio is an assurance of quality as it establishes a minimum standard below which the acute care hospitals should not fall below as far as health care is concerned. For instance, in cases of surgeries, a patient requiresat least one nurse by the bedside who will monitor the progress of the patient. The case would be different if one nurse has to attend to a number of patients recovering from a surgery since it is challenging to keep track of all the changes that occur in the patients during the healing process.

Improved Working Conditions

Christman(1981) argues that the working conditions have a critical influence on the willingness of people to work particularly in acute care hospital. Staffing ratio will help alleviate then shortage since the minimum staffing ratio would improve the working conditions which in turn help resolve the workforce issue. In any profession, the personnel requires a suitable working condition whereby a person does not become so overwhelmed at the end of the day due to the amount of workload done during the day. Therefore the ratio will encourage the nurses and hence reduce the number of nurses leaving the nursing professionsand hospital positions. Better working conditions would also attract more individuals mainly the youths in the profession which in turn will help deal with the staffing challenges.

Nayar(2008) explains the costs associated with the staffing of the acute care hospitals for both the patient and the hospital management. The most important factor is the satisfaction of the patient by receiving the best medical care which can only be achieved by ensuring the hospitals are well staffed. Staffing of the hospitals comes with its associated cost which may be a challenge as at times the costs outweigh the benefits. However, by ensuring a reasonable nurse to patient ratio, the potential cost is reduced and translates to a financial breakthrough for the hospitals. Adequate staffing in a hospital reduces the waiting time which means many patients can be attended to at the same time. This, in turn, means that the number of patients treated in a given day increases and therefore the benefits derived from the same also increases. However, the benefits associated with adequate staffing are weightier on the quality of care compared to the financial results, staffing increase has a great impact on the financial status of the hospitals.

The quality of care in acute care hospital is associated with acomplex array of theorganization as well as the patients’ characteristics. According to Kalisch& Lee, (2011)hospitals with better organizational culture have best patient outcomes since the staff is involved in decision making in the organization.  Minimum nurse to patient ration could lead to hospitals focusing on the staffing and forgetting about other factors critical to the quality of care.  Although the ratio could be the answer to the staffing challenges in the hospitals, they may also create perverse incentives for hospitals.


Consequently addressing the minimum staffing ratio only solve one aspect of the dissatisfaction from the hospital staff. Althoughstaffing is a major concern in the hospitals, a number of issues lead to the challenges faced in the acute care hospitals on the staff side. According to Kovner, Jones &Gergen, (2000) the staff face challenges and are dissatisfied with other aspects of their profession such as lack of advancement opportunities, low salaries, lack of input in management and policy decisions and inadequate support staff. Acute care hospitals are not only concerned with the staffing in the medical field, it also involves staff performing non-medical tasks. Poor management may lead to inadequate staffing on the non-nursing tasks which translate to the medical practitioners doing tasks that do not align with their profession. As such the nurse-patient ratio may not yield great benefits to the patients and nurses as expected. It is, therefore, the role of management of the hospitals to maintain a balance in staffing to ensure the challenges are addressed ranging from the nursing to non-nursing challenges experienced in the acute care hospitals.




Christman, L. (1981). Factors Affecting Nurse Staffing in Acute Care Hospitals: A Review and   Critique of the Literature. Nursing Administration Quarterly5(4), 110-111.

Kalisch, B., & Lee, K. (2011). Nurse Staffing Levels and Teamwork: A Cross-Sectional Study of            Patient Care Units in Acute Care Hospitals. Journal Of Nursing Scholarship43(1), 82-     88.

Kovner, C., Jones, C., &Gergen, P. (2000). Nurse Staffing in Acute Care Hospitals, 1990-            1996. Policy, Politics, & Nursing Practice1(3), 194-204.

McHugh, M., Berez, J., & Small, D. (2013). Hospitals With Higher Nurse Staffing Had to Lower             Odds Of Readmissions Penalties Than Hospitals With Lower Staffing. Health          Affairs32(10), 1740-1747.

Nayar, P. (2008). The impact of Medicare’s Prospective Payment System on staffing of long-        term acute care hospitals. Health Care Management Review33(3), 264-273.


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