Nurse-to-patient ratios.

ply of nurses and better track and disseminate information on patient outcomes and nurse workloads. While there is much debate about the pros and cons of these alternatives, participants at the 25th Massachusetts Health Policy Forum generally agreed on the following points: • The number of staff nurses and their skill play a critical role in patient outcomes across a range of conditions in the hospital setting. • Patient outcomes depend not only on the kind and severity of patients’ illnesses, but also on the mix of nurses, doctors, and auxiliary personnel, and on the work environment or culture of the hospital. • The nursing shortage in the state and nation presents challenges for hospitals in changing the number and mix of staff nurses. • It is questionable whether research will ever be able to show the optimal nurseto-patient ratio. • Enforcement of any nurse staffing reform will be challenging, as the usual penalties for noncompliance, such as fines, could have a detrimental effect on access to care. • Regardless of the path that nurse staffing reform takes, the government, hospitals, nurses, doctors, insurance companies, and patients must put aside their differences and work together to make the reform successful.