What Would #ThisNurse Say? Consumers, Hospitals & Data Holes

As I return to my analysis of New York Times nursing coverage after a semester break in Brazil, nursing’s recent front-page spread tempted me.  But to discuss Dionne Searcey, Eduardo Porter and Robert Gebeloff’s  article would only encourage you to read it.

Instead, I’ll push past, hoping that others see nursing as different from telephone repair, and that too many folks don’t start joining the profession just for a bigger paycheck. I want to highlight content that will further the profession and its voice in the media, not journalism that sells nursing as a solution for jumping classes.

Wednesday’s editorial, “Is That Really a Five-Star Nursing Home?”, provided a perfect replacement. In it, the Editorial Board told of Medicare’s new algorithm for telling the public which nursing homes are good or not. Go figure, the data on Nursing Homes Compare (a Medicare website similar to Hospital Compare), largely based on staffing and quality, was quite inflated; a third of the facilities lost their five-star rating after these new standards launched.

What excited me most wasn’t the promise of more accurate data, though. It was the info-heavy statement at the very end of the article:

“Perhaps the most important improvement is that by the end of 2016, the government will require all nursing homes to report staffing levels — an important determinant of quality — every quarter, using an electronic system that can be verified with payroll data.”

I’m a hospital nurse, not a nursing home nurse, and I’ve often wondered why my patients and their families lacked insight into the data behind how I do my job (how many hours I spend with each patient), or with what tools (how many patients I care for, and my level of education). While Hospital Compare provides data on quality measures, it doesn’t report or link these measures to staffing, as the Times just did in this editorial’s final statement.

In comparison, Nursing Home Compare lists staffing data for consumers to view and weigh. So, if I’m looking for a nursing home for my 97-year-old grandma, I can compare the ones in my neighborhood, and see how much time nurses spend with each resident. Even though these numbers are bloated (I mixed some basic math with some basic logic), they offer a baseline for consumers to judge from. I’d venture to guess that everyone in Big Mac America knows that more time with patients is better than less.

If I’m looking for a nursing home, this data is lovely. But my grandmother doesn’t need a nursing home. I’m shopping around for a quality hospital to care for my 57-year-old mom, who might need back surgery. Thanks to this Medicare data mismatch, I have no way of obtaining hospital staffing data. Sure, I can find info on back surgeons, but after the surgery is over, my mom will rely on nurses for her recovery. And if the Times editors just said what I think they just said – staffing should be transparent because it directly affects quality – this omission of information makes me a really unhappy consumer.

Since the government does not currently mandate reporting on hospital staffing, I, as a consumer, have no way of knowing anything about this, or where to find answers. I’m in the dark as to how each hospital staffs, which hospitals hire nurses with Bachelor’s degrees, or how one hospital compares to another in nursing care hours – all data-driven measures on the road to quality. Instead, I’m left guessing about an enormous determinant to quality for a life-altering, expensive transaction. Shocking, considering the level of analysis we demand when purchasing even simple electronic equipment.

In a world where health care bankruptcy reigns and technology creates consumer transparency for everything from cars to shaving cream, omitting information on hospital staffing is pretty senseless. And so, I’m a bit encouraged by what the Times did with this little editorial: By showing what’s becoming transparent, it highlighted what is still dangerously hidden.

As I return to my analysis of