By Josh Brokaw
Under a New York State law passed in 2010 and made effective by the state Department of Health in 2015, hospitals and nursing homes are required to disclose a certain number of “nursing quality indicators” for the previous 12 months whenever a request is made by any member of the public.
This reporter has made two requests for this data to Cayuga Medical Center in the last year. The first was made in November 2016, with a response coming in December that I just never got around to publishing until now. I made the second request in late May; Cayuga Medical vice president of public relations John Turner sent that latest batch of data to TruthSayers on July 5.
The first response from CMC did not come with any numbers for the Emergency Department, which, given the incidents there in the last year, seemed concerning. A request to Turner asking why there was no Emergency Department data was ignored. After including a specific plea to include Emergency Department data in my second request, you can see that some of the indicators for the ED were listed. I followed up on July 30 with Turner, asking why no staffing plan for any department had been included, and why the Emergency Department had less indicators listed than other departments. This was Turner’s response:
“With regard to your clarification of information related to the ED and total patient falls per 1,000 patient days. That stat is only for inpatient units and does not apply to the ED. I am forwarding you the daily staffing sheet used by the ED, which develops our staffing plans. Emergency Department acuity varies from day to day and we staff according to census and acuity. Here is our staffing model for the ED:
7am-11am – 5 RNs
11am to 3 pm – 7 RNs
3pm to 7 pm – 8 RNs
7 pm to 11pm – 8 RNs
11pm to 3am – 6 RNs
3am to 7am – 5RNs
In addition, the ED and other patient care units conduct daily patient safety briefings four times per day to review acuity and staffing.”
Here’s a spreadsheet I made from the data Cayuga Medical has disclosed to TruthSayers so far. You can scroll down to see the data as it was originally provided.
It would be fantastic to collect this information from more hospitals, but I don’t have the time to hassle the several hundred hospitals in New York State. So, readers, it is time for you to become a reporter. Pick a hospital, find the relevant person who handles the public, and send them a variety of this request:
Dear [Hospital Representative],
I would like to request that [Hospital Name] provide the following information for the 12 months preceding [today’s date].
(1) nurse staffing indicators and nurse-sensitive patient outcome indicators, from every department at [Hospital Name], including the Emergency Department.
(2) The procedures and processes used for determining and adjusting staffing levels based on patient case mix and acuity; from every department at [Hospital Name], including the Emergency Department.
(3) The final conclusions of any complaint investigations filed with any state or federal regulatory agency or accrediting agency and any citations resulting from surveys; and
(4) The sources and dates for data disclosed.
Please refer to New York State Title 10, Section 400.25, for definitions of the requested nurse staffing and patient outcome indicators, and for detailed information about how this data should be presented.
If you have any questions, feel free to call me at [number] or email me at this address.
With more data, we can start making comparisons of what a “competitive” nurse to patient ratio looks like in New York hospitals, and when those ratios start dipping, we’ll know to start asking why.
When you submit a request, let us know – drop us a line in the “contact us” box – and when the data starts coming in we’ll set up a public spreadsheet to make referencing the the numbers easy and transparent.
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