Nursing prof studies hospital restructuring

Nursing Professor Margaret Sovie recently began an extensive study on the affects of hospital restructuring on patient care -- after receiving a whopping $1.6 million in federal grant money. "The '90s have been marked by hospital restructuring," Sovie said, explaining that medical professionals must now examine the effects of such changes. "Hospitals have got to lower the cost [of health care] but improve quality," she added. Nursing Dean Norma Lang applauded the project several weeks ago because "any restructuring and reengineering is going to have an effect on nursing." She noted that Sovie's study received "one of the largest grants ever." The "Hospital Restructuring's Impact on Outcomes" report will study patient experiences in 30 university teaching hospitals across the country, each of which fills at least 300 beds per day. The Hospital of the University of Pennsylvania is one of the institutions participating in the study, along with other highly ranked hospitals at Georgetown, Stanford and New York universities. But although Sovie described HUP as one of the many "institutions that set the standards," she maintained that her study is "not directed at HUP." The ramifications of hospital restructuring is particularly important to the Nursing School because nurses are often fired when hospitals hire uncertified staff -- which may harm patient care. "The evidence that we have thus far points out a direct relationship between a high [registered nurse] staff mix and better outcomes," she explained. "[But nurses have] been asked to do more with less," she added. Sovie stressed that her role as a nurse will not affect the study, which she said will provide empirical data on hospital restructuring. "We have no a priori hypothesis," Sovie said, adding that "we hope to? share findings with the industry and policy makers." Chief nursing officers from hospitals participating in the study will collect data on patient outcomes under a variety of variables for the next year-and-a-half, and Sovie will release the final report in 1999. Sovie explained that during the course of the study, the care given to every patient in the participating hospitals will be reviewed once a month. She noted that such a large volume of cases will insure that the final results will have a 95 percent confidence level. She added that the study will only look at data aggregated from all of the participating hospitals, and will not include information on individual institutions. Administrators at the participating hospitals, however, will be able to look at their individual results -- allowing them to make any necessary changes in how their hospitals care for patients. As is common in many Nursing School research projects, Sovie's research team will include at least one University student -- in this case, Nursing sophomore Valerie Fields. "I want to get the most I can out of my experience at Penn, and I know that research is a big aspect of it," Fields said in explaining her reasons for joining the study.