Appropriate Staffing Effects on Patient Outcomes and Healthcare Quality

Chronic disease in the US is rampant, therefore, it is crucial to research this topic and all the possibilities on improving the lives of people with chronic illnesses. Millions of Americans have one or more chronic health issues, with the number projected to be up to 155 million in 2020 (Poghosyan et al., 2018). The PICOT question for this essay is the following: for patients with chronic diseases, does inappropriate staffing as compared to appropriate staffing promote poor patient outcomes and healthcare quality? In order to answer this question, this essay reviews two scholarly articles that study the effects of quality and quantity of staff on adverse outcomes for patients with chronic diseases.

The first article is “Organisational quality, nurse staffing, and the quality of chronic disease management in primary care: Observational study using routinely collected data” by Griffiths et al. Studies described in this paper show demands for highly educated nursing staff (Griffiths et al., 2011). It discusses the relation of the level of nursing to the quality of care and positive patient outcomes, as well as attempts to determine the influence of organizational factors on them.

The second article is “Nurse practitioner practice environments in primary care and quality of care for chronic diseases” by Poghosyan et al. It studies the methods of optimization of the nurse practitioner (NP) workforce in order to positively affect outcomes of chronic diseases in the United States. The article’s objective is to determine the impact of the adequate working environment on the quality of care of patients with chronic conditions.

Both articles refer to both organizational and qualification aspects of staff, and their relation to the quality of care and number of positive outcomes. These articles provide data necessary to answer the PICOT question of this essay, such as the importance of proper policies and relationships within the healthcare facility. They also discuss the effects of staff qualification and stress on positive outcomes.

The patient groups that were chosen in these two articles are people with long-term health issues who received hospital care from various hospitals in the United States and the United Kingdom. Researchers were granted access to electronic health records and analyzed the available information regarding patient satisfaction with nursing personnel and the outcome of each visit. Moreover, in both papers, analyzed data includes self-reported organizational factors from healthcare facilities that participated in these studies. The second article also consists of a survey of NPs regarding their working environment, and performance of each clinic and hospital using HEDIS measures. Both articles’ chosen groups and methods of study are closely related to the selected PICOT question.

The primary method of data collecting is similar in both papers, and it provides the average reported quality of care and takes into consideration various chronic diseases. Moreover, it allows researchers to use software to generate meaningful statistics that depict the relationship between organizational factors and patient outcomes and satisfaction. However, there are some limitations that apply to each chosen study. Before coming to any conclusions, Poghosyan et al. (2018) notify that by taking a small sample of NPs, they “limit the generalizability of the findings” (p. 796). Moreover, researchers were unable to link the data from healthcare facilities with surveyed NPs. Griffiths et al. (2011) warn that their model “lacked measures of staff wellbeing and perceptions of organizational climate” (p. 1208). Their study also does not include any data from rural clinics and hospitals.

Key findings from both articles suggest that the higher the quality of human resources available to the clinic and the more organized its management is, the lower the number of adverse patient outcomes. Poghosyan et al. (2018) state that “patients with chronic diseases counseled by NPs have significantly lower systolic blood pressure and cholesterol levels compared to patients counseled by physicians alone” (p. 792). Moreover, Poghosyan et al. (2018) found that “a lack of support for NP independent practice may negatively impact the quality of care delivered to patients with chronic diseases” (p. 797). The abundance and availability of highly trained personnel, in general, is vital for human society, and especially crucial nowadays for people with chronic diseases since the percentage of population afflicted by them rapidly increases (Griffiths et al., 2011). These two studies signify the importance of training nurse practitioners’ leadership skills in order to create sustainable organizational structures and promoting higher education for nursing personnel.

The anticipated outcome for the PICOT question posed in this essay was a positive correlation between adequately trained medical staff, patient outcomes, and the quality of care. The results of the studies presented in these two articles support this outcome, show the importance of adequately structured nursing teams and healthcare facilities in general. Poghosyan et al. (2018) conclude that “promoting NP practice environments leads to better chronic care delivery” (p. 797). Griffiths et al. (2011) find that “the global effect of the practice nurse staffing was statistically significant”(p. 1204). The care for patients with chronic diseases is especially vulnerable to organizational issues because it demands continuity of data and adequately shared knowledge among medical personnel.


Griffiths, P., Maben, J., & Murrells, T. (2011). . International Journal of Nursing Studies, 48(10), 1199–1210. Web.

Poghosyan, L., Norful, A. A., Liu, J., & Friedberg, M. W. (2018). . Medical care, 56(9), 791–797. Web.

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