NHS FPX 6008 Assessment 4 Lobbying for Change
Student Name
Capella University
NHS-FPX 6008 Economics and Decision Making in Health Care
Prof. Name
Date
Lobbying for Change
The Honourable Mr. Chris
Governor of Upper Manhattan Region
622 W 168th St, New York, NY 10032
United States
Dear Mr. Chris,
I am writing to formally advocate for strengthening registered nurse (RN) staffing ratios at NewYork-Presbyterian Hospital. Based on professional observation in healthcare settings, insufficient nursing staff has consistently been associated with reduced patient safety, poorer clinical outcomes, and increased strain on healthcare workers. Current staffing limitations contribute to preventable risks such as higher mortality rates, increased nurse exhaustion, and avoidable financial pressure on hospitals due to extended admissions and readmissions (NewYork-Presbyterian Hospital, 2024).
Purpose of the Advocacy
The central aim of this letter is to highlight the importance of safe RN staffing levels and encourage policy-level action. Improving staffing ratios is not only a workforce concern but also a critical patient safety issue that directly influences healthcare quality and system efficiency.
Key expected benefits of improved staffing include:
- Enhanced patient survival and recovery outcomes
- Reduction in medical errors and hospital-acquired complications
- Improved nurse satisfaction and reduced burnout
- Lower healthcare costs through fewer readmissions
Impact of RN Staffing Ratios on Healthcare Outcomes
Adequate nurse staffing has a measurable effect on both clinical and organizational performance. Research consistently shows that hospitals with better staffing ratios achieve stronger patient outcomes and operational efficiency. Conversely, understaffing increases risks across multiple dimensions of care delivery.
Table 1
Relationship Between Nurse Staffing and Healthcare Outcomes
| Staffing Condition | Patient Outcomes | Workforce Impact | Financial Impact |
|---|---|---|---|
| Adequate staffing | Lower mortality, fewer complications | Higher job satisfaction | Reduced costs from fewer readmissions |
| Inadequate staffing | Increased adverse events and infections | Burnout and turnover | Higher long-term hospital expenses |
Lasater et al. (2021) found that hospitals maintaining safe staffing standards experience both improved patient outcomes and significant cost reductions due to fewer complications and readmissions.
Evidence Supporting Safe Staffing Policies
Multiple studies reinforce the importance of maintaining appropriate RN-to-patient ratios. Increased workload per nurse has been directly associated with higher mortality risk and reduced quality of care delivery.
Table 2
Summary of Research on RN Staffing Effects
| Study | Key Finding | Implication |
|---|---|---|
| Twigg et al. (2021) | Each additional patient per nurse increases mortality risk by 7% | Staffing levels directly affect survival outcomes |
| Lasater et al. (2021) | Safe staffing reduces infections and improves satisfaction | Quality of care improves with adequate staffing |
| McHugh et al. (2021) | Higher staffing reduces 30-day readmissions | Long-term cost savings for hospitals |
| Poku et al. (2025) | Better staffing reduces burnout and turnover | Workforce sustainability improves |
| ANA (2022) | Supports legislation for safe staffing ratios | Policy support for standardized staffing |
These findings collectively reinforce the need for structured staffing policies to ensure consistent, safe, and equitable healthcare delivery.
Workforce and Public Health Implications
The nursing workforce plays a critical role in shaping public health outcomes. In the United States, approximately 3,072,670 registered nurses serve the population, averaging about 9.22 nurses per 1,000 individuals. In New York State, the ratio is slightly higher at 9.68 nurses per 1,000 residents (Feeney, 2022). Despite these figures, uneven distribution and staffing shortages persist in many healthcare facilities.
NHS FPX 6008 Assessment 4 Lobbying for Change
Understaffing contributes to:
- Increased medical errors and delayed interventions
- Higher nurse burnout and turnover rates
- Widening healthcare disparities in underserved populations
Twigg et al. (2021) further emphasize that insufficient staffing significantly elevates patient risk, particularly in high-demand hospital environments.
Professional Experience and Risk Management Perspective
My background in patient safety and risk management has provided practical insight into how staffing shortages influence clinical and operational risk. Insufficient RN coverage has been linked to increased patient falls, medication errors, and staff exhaustion.
Through this experience, I have learned to:
- Identify risks early through structured analysis
- Allocate resources more efficiently
- Support staffing decisions using data-driven approaches
- Integrate technology to improve workflow efficiency
This risk-based perspective reinforces the importance of proactive staffing strategies to prevent adverse outcomes rather than reacting to them after harm occurs.
Call to Action
I respectfully encourage support for legislative and institutional policies that establish safe RN-to-patient staffing ratios at NewYork-Presbyterian Hospital and across similar healthcare facilities. Strengthening staffing structures will:
- Improve patient safety and clinical outcomes
- Reduce avoidable healthcare costs
- Support nurse retention and workforce sustainability
- Promote equitable access to high-quality care
Thank you for your time and consideration. I welcome the opportunity to further discuss this matter and collaborate on solutions that strengthen healthcare delivery systems.
Sincerely,
Angela
References
American Nurses Association (ANA). (2022). Nurse staffing advocacy. American Nurses Association. https://www.nursingworld.org/practice-policy/nurse-staffing/nurse-staffing-advocacy/
Feeney, A. (2022). The U.S. nursing shortage: A state-by-state breakdown. NurseJournal.org. https://nursejournal.org/articles/the-us-nursing-shortage-state-by-state-breakdown
Lasater, K. B., Aiken, L. H., Sloane, D., French, R., Martin, B., Alexander, M., & McHugh, M. D. (2021). Patient outcomes and cost savings associated with hospital safe nurse staffing legislation: An observational study. BMJ Open, 11(12), e052899. https://doi.org/10.1136/bmjopen-2021-052899
NHS FPX 6008 Assessment 4 Lobbying for Change
McHugh, M. D., Aiken, L. H., Sloane, D., Windsor, C., Douglas, C., & Yates, P. (2021). Effects of nurse-to-patient ratio legislation on nurse staffing and patient outcomes. The Lancet, 397(10288), 1905–1913. https://doi.org/10.1016/S0140-6736(21)00768-6
NewYork-Presbyterian Hospital. (2024). Department of nursing – Overview. https://www.nyp.org/morganstanley/for-health-professionals/nursing-and-patient-care-services/department-of-nursing-overview
Poku, C. A., Bayuo, J., Agyare, V. A., Sarkodie, N. K., & Bam, V. (2025). Work engagement, resilience and turnover intentions among nurses: A mediation analysis. BMC Health Services Research, 25(1). https://doi.org/10.1186/s12913-025-12242-6
NHS FPX 6008 Assessment 4 Lobbying for Change
Twigg, D. E., Whitehead, L., Doleman, G., & Zaemey, S. E. (2021). The impact of nurse staffing methodologies on nurse and patient outcomes: A systematic review. Journal of Advanced Nursing, 77(12). https://doi.org/10.1111/jan.14909