Jack Needleman and colleagues examine different nurse staffing arrangements in their 2006 Health Affairs article entitled “Nurse Staffing in Hospitals: Is There a Business Case for Quality?” (see the Reference list for a complete citation of the article). In this study, the authors used nurse staffing and patient discharge data from 799 U.S. hospitals to simulate three different nurse staffing approaches and to determine which of these options produced the greatest cost savings. Read this article, and then answer the following questions.

Questions
1. Assume that you are the manager of a 30- bed general medical-surgical unit at a 200-bed community hospital. How can you use the findings from this article to help make staffing decisions on your unit?

2. What other important data sources will you examine before making a decision to increase or decrease the nurse-to patient ratio?
3. Now consider that you are the chief executive officer at a large academic health hospital in an urban setting. Over the next two years, the nurse staffing ratio on the general medical-surgical units in your facility is projected to decrease from 1 nurse per 6 patients to 1 nurse per 4 patients. How will you estimate the costs and savings of such a change? Be sure to consider the organization’s philosophy of care in your evaluation plan.