api healthcare overtime webinar
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Overtime
50% of full time nurses work OVERTIME
Source: Bae, Sung-Heui. "Nursing Overtime: Why, How Much, and Under What Working Conditions?" Nursing Economics, 30, no 2 (March/April 2012): 60-71.
Full time nurses work an average
of 7 OVERTIME hours each week
Overtime Hours
Source: Health Resources and Services Administration, "The Registered Nurse Population. September 2010," Accessed July 28, 2014, http://bhpr.hrsa.gov/healthworkforce/rnsurveys/rnsurveyfinal.pdf
Total Cost of OVERTIME = $12M
Based on a 300 bed hospital
Cost Implications
Source: Sage Growth Partners Analysis
Obvious Costs
Full Time Nurses 7 Hours Average
overtime(3)
75% Full Time Nurses(1)
25% Part Time Nurses(1)
Part Time Nurses 5.4 hours
Average
overtime(3)
Roughly 7.5% of Total Hours Worked are Overtime
50% Working
overtime(2)
15.1% Working
overtime(2)
(1) Health Resources and Services Administration, "The Registered Nurse Population. September 2010," Accessed July 28, 2014,
http://bhpr.hrsa.gov/healthworkforce/rnsurveys/rnsurveyfinal.pdf
(2) Sung-Heui Bae, "Nursing Overtime: Why, How Much, and Under What Working Conditions?" Nursing Economics, 30, no 2 (March/April 2012): 60-71.
(3) Health Resources and Services Administration, "The Registered Nurse Population. September 2010," Accessed July 28, 2014,
http://bhpr.hrsa.gov/healthworkforce/rnsurveys/rnsurveyfinal.pdf
Nurses who work OVERTIME are
to make medical errors
3X more likely
Medical Errors
Source: Bae, Sung-Heui. Presence of Nurse Mandatory Overtime Regulations and Nurse And Patient Outcomes. Nursing Economics. March/April 2013; 31, no. 2: 59-89.
Medical Errors: Key Facts
• 3rd leading cause of death in the US(1)
• According to multiple studies, overtime among nurses increases the likelihood of errors by 1.46 to 3.71 times more than a nurse who did not work overtime. (2,3)
– Risk almost doubles when nurses worked 12.5 or more consecutive hours(3)
– Medication errors 3.71 times more likely when nurses work 40+ hours(2)
(1) Allen, Marshall. “How Many Die from Medical Mistakes in U.S. Hospitals?” ProPublica September 19, 2013. http://www.propublica.org/article/how-many-die-from-medical-mistakes-in-us-hospitals (2) Presence of Nurse Mandatory Overtime Regulations and Nurse And Patient Outcomes, Nursing Economics, 2013.
(3) Effects of Critical Care Nurses’ Work Hours on Vigilance and Patients’ Safety, American Journal of Critical Care, 2006.
Medical Error SAVINGS = $663,376
Potential Savings Medical Errors Overtime
Overtime SAVINGS = $1,154,828
Nurses working 12 hour shifts are
to intend to 2X more
likely
leave their job within 1 year
Turnover
Source: Stimpfl, Amy, et al. The Longer The Shifts for Hospital Nurses, The Higher The Levels Of Burnout And Patient Dissatisfaction. Health Affairs, 31, no.11 (2012): 2501:2509.
Staff Nurse Turnover: Key Facts
• Overworked nurses are 1.772 times more likely to quit than your average nurse due to physical and emotional fatigue.(1)
• Average cost to replace a nurse is $82,000(2)
• Average turnover rate for nurses is 14%(3)
(1) Health Affairs, “The Longer The Shifts For Hospital Nurses, The Higher The Levels Of Burnout And Patient Dissatisfaction” (2) Revisiting Nurse Turnover Costs: Adjusting for Inflation, Journal of Nursing Administration (3) KPMG Survey, "Nursing Labor costs."
Turnover SAVINGS = $761,405
Potential Savings Turnover
Medical Errors Overtime
Overtime SAVINGS = $1,154,828
Medical Error SAVINGS = $663,376
patients are more likely to rate hospital 6 or lower out of 10 on HCAHPS survey
Patient Satisfaction
Source: Stimpfl, Amy, et al. The Longer The Shifts for Hospital Nurses, The Higher The Levels Of Burnout And Patient Dissatisfaction. Health Affairs, 31, no.11 (2012): 2501:2509.
Lifetime Value of
Patient = $150,000
Lifetime Value of
Household = $404,000
Value of Patient
Source: Wolf, Jason and Widmer, Thomas. "Return on Service The Financial Impact of the Patient Experience." 2011
(1) Health Affairs "Nurses' Widespread Job Dissatisfaction, Burnout, & Frustration with Health Benefits Signal Problems for Patient Care." (2) J.D. Power and Associates National Hospital Service Performance Study: (2005) (3) Kavaler and Speigel. Quoted by FACS http://www.facs.org/cancer/schedules/ogrady-dashboard.pdf
Patient Satisfaction: Key Facts
• Recommendations to hospitals decreased by 2% for every 10% of nurses reporting dissatisfaction(1)
• HCAHPS Scores - 7 or lower = 37% retention rate(2)
- 8 or higher = 80% retention rate(2)
• LTV of Patient = 40 years, $400k (potential to lose $8MM)(3)
Patient Satisfaction
Patient Satisfaction SAVINGS = $793,892
Potential Savings Turnover
Medical Errors Overtime
Overtime SAVINGS = $1,154,828
Medical Error SAVINGS = $663,376
Turnover SAVINGS = $761,405
Overtime Schedules are associated with a
61% Increased Injury rate
Nurse Injuries
Source: Occup Environ Med. "The Impact of overtime and long work hours on occupational injuries and illnesses: new evidence from the United States. 2005;62:588-597" Accessed July 10, 2014.
(1) OSHA " Worker Safety in the Hospital - Know the facts" Sept 2013 (2) Occup Environ Med. "The Impact of overtime and long work hours on occupational injuries and illnesses:
new evidence from the United States
Employee Injuries: Key Facts
• The average injury rate for healthcare workers is 6.8% (twice the rate of other industries).(1)
• The average cost of a work related injury is $15,860.(1)
• 61% higher injury rate because of overtime schedules
(fatigue and stress)(2)
Employee Injury SAVINGS = $100,841
Potential Savings Turnover
Medical Errors Overtime
Patient Satisfaction
Employee Injuries
Overtime SAVINGS = $1,154,828
Medical Error SAVINGS = $663,376
Turnover SAVINGS = $761,405
Patient Satisfaction SAVINGS = $793,892
Broader View
Industry Challenges +
Overtime
Overtime
Medical Errors
Turnover
Agency Dependency
Nurse Manager Productivity
Employee Injuries
Patient Satisfaction
Potential Savings Turnover
Medical Errors Overtime
Patient Satisfaction
Employee Injuries
Overtime SAVINGS = $1,154,828
Medical Error SAVINGS = $663,376
Turnover SAVINGS = $761,405
Patient Satisfaction SAVINGS = $793,892
Employee Injuries SAVINGS = $100,841
Total Potential SAVINGS = $3,474,342
Thank You!
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Questions? Email Joe Strick: [email protected]