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“It became remarkably apparent to me how critical nurses were in the delivery of patient care.”

The COVID-19 public health emergency revealed many serious problems in the nation’s healthcare system. For health services researcher Karen B. Lasater, Ph.D., R.N., FAAN, it demonstrated that hospitals provide safer, higher-quality care when they are adequately staffed with well-trained nurses.

“Patients in hospitals that had poor nurse staffing ratios before the pandemic were 20 percent more likely to die in the hospital during the pandemic,” says Dr. Lasater, associate professor of nursing at the University of Pennsylvania, citing from AHRQ-funded research she has performed. “Nurses are the last line of defense for patient safety, but they are too often working under unnecessarily constrained resources in high-pressure environments that risk potentially fatal errors.” 

Dr. Lasater, who is also a senior fellow at Penn’s Leonard Davis Institute of Health Economics, received a 3-year ������Ƶin 2022 to assess the preparation, response, and recovery of hospital nurses and patient outcomes during the pandemic. She is leading a team of researchers who are reviewing data from approximately 250 hospitals, linked with patient claims data to study health outcomes. 

Dr. Lasater and her colleagues are evaluating the extent to which hospital nursing resources (such as staffing) affected nurses’ performance and job satisfaction. They are also evaluating whether changes in patient outcomes parallelled changes in nurse outcomes and hospital nursing resources. Findings from this research will inform how to sustain safe, high-value healthcare systems that can endure future public health emergencies and thrive during ordinary times. Her project ends August 31, 2025.

Over her career, Dr. Lasater has aimed to shed light on the challenges faced by healthcare workers and, therefore, on patients. Her research explains the value of nurses and makes a business case for investing in hospital nursing.

“It became remarkably apparent to me how critical nurses were in the delivery of patient care,” Dr. Lasater says. “The thing that stayed with me from my earliest clinical experiences, was how important the work of nursing is and at the same time how under-resourced those nurses were. The importance of the work did not match the level of support and protection that was necessary for nurses to care for patients.”

Dr. Lasater’s research goal is ensuring that hospitals are adequately staffed to meet the public’s healthcare needs in both ordinary times and during a public health emergency. She adds: “This is foundational for establishing a healthcare system that can reliably deliver safe, high-value healthcare.” 

Principal Investigator: Karen Blanchette Lasater, Ph.D., R.N., FAAN
Institution: University of Pennsylvania
Grantee Since: 2023
Type of Grant: Research Project Grant 

Related ������ƵResources

• Surveys on Patient Safety Culture® 
• Communication and Optimal Resolution (CANDOR) Toolkit