March 2, 2015

Addressing The Nurse Shortage To Improve The Quality Of Patient Care


Nurses are the largest group of health care professionals providing direct patient care in hospitals, and the quality of care for hospital patients is strongly linked to the performance of nursing staff, according to an Institute of Medicine report. This paper describes the Robert Wood Johnson Foundation’s (RWJF’s) work in nursing, which focuses on improving the hospital work environment to attract and retain high-quality nursing staff, with the ultimate goal of improving patient care and outcomes in hospitals. Other organizations’ efforts to address the nurse shortage are also explored.

THE ROBERT WOOD JOHNSON Foundation (RWJF) is dedicated to improving the health and health care of all Americans. Central to this mission is transforming the way care is delivered at the bedside to reduce the shortage in nurse staffing and improves the quality of nursing care.

Nurses are the linchpins in providing high-quality patient care in hospitals. To attract high-quality staff, enable them to do their best work, and keep them as long-term employees, improvements must be made in the organization of work and use of information technology (IT); physical design and allocation of space; and hospital leadership and culture. Working with various partners, the RWJF expects to build support for a new kind of hospital that reflects the needs and realities of the twenty-first century: a hospital where patient safety is assured, quality of care is paramount, efficiencies are maximized, and staff are satisfied with and actively supported in their jobs.

Although this initiative begins with the nursing profession, the results from these efforts are expected to affect all health care workers in hospitals and the millions of patients whom they serve.

A ‘Perfect Storm’ For Nurses And Patients

Throughout the past few decades, U.S. hospitals have faced cyclical shortages of nurses; in 2000 an estimated 126,000 hospital nursing positions were unfilled.2 The percentage of nurses working in hospitals dropped from 59 percent in 2000 to a little more than 56 percent in 2004.3 The current nurse shortage is driven by a broad set of factors related to recruitment and retention among them, fewer workers, an aging workforce, and unsatisfying work environments that have contributed to a different kind of shortage that is more complex, more serious, and expected to last longer than previous shortages.

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