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Nursing and Other Determinants of Hospital Level Outcomes

Study Overview

Both mortality and readmission rates are used as indictors of the quality of hospital care. The general rationale for their use as indicators of quality is that some hospitals have structures and processes that minimize avoidable or unnecessary patient deaths and readmissions better than other hospitals.

The challenge has been and continues to be to discover and explain what facet of hospital structures and processes act to minimize patient readmissions and deaths. Historically, the study of determinants of 30-day mortality and readmission rates for hospitalized patients has focused on the exploration of medical processes of care and patients’ own characteristics. Until recently, little focus has been placed on studying nursing-related structures and processes that might influence mortality for hospitalized patients.

Study Purpose

The purpose of this study was to propose and test theoretical models describing relationships between nursing related and other hospital characteristics with two hospital quality of care indicators: 30-day mortality and 30-day readmission to hospital rates. Nursing related hospital characteristics such as nurse staffing, nurse experience, nursing care delivery system, condition of the nursing practice environment, and nurse response to these environments are included in the theoretical models.

Research Team

This study was conducted by a team of researchers: Ann Tourangeau, Diane Doran, Dorothy Pringle, Linda McGillis Hall, Linda O’Brien-Pallas and Anil Verma from the University of Toronto and Jack Tu from the Institute for Clinical Evaluative Sciences.

This research was initiated in October 2002 and was funded by the Canadian Institutes of Health Research and the Canadian Health Services Research Foundation in partnership with the Nursing Research Fund and the Ontario Ministry of Health and Long-Term Care.

This study is now complete.

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