Mayo Clinic Health System is a name that conjures up images of world-class healthcare and cutting-edge medical treatment for many people in Minnesota. However, a troubling trend has emerged, as the Minnesota Department of Health (MDH) reported that Mayo Clinic Health System had the highest number of adverse health events in the state last year. We know that the root cause of this problem lies in their profit-driven business decisions that include high nurse-to-patient staffing ratios.
In 2003, Minnesota became the first state to require hospitals to report, conduct a root cause analysis on and submit the findings and corrective action plan(s) on 28 “never events” that are considered preventable errors in hospitals. For the past 20 years, MDH has released a report detailing how many adverse events occurred in Minnesota hospitals. It is important to remember that adverse health events are preventable medical errors that cause serious injury and death to patients.
In the most recent report, the two highest categories of adverse events are pressure ulcers and falls. Uncoincidentally, these two results are also Nurse Sensitive Indicators (NSIs) or specific patient outcomes that are influenced by nursing care and, directly related to nurse staffing levels. High nurse-to-patient staffing ratios only exacerbate the risk of adverse event occurrences by overburdening nurses and creating conditions where nurses are not able to provide quality patient care.
This data comes as we still deal with the consequences of Mayo’s blackmail to the Governor that killed MNA’s Keeping Nurses at the Bedside Act (KNABA). KNABA was MNA’s proposed legislation in the 2022 and 2023 legislative sessions that aimed at improving patient care by ensuring appropriate nurse-to-patient staffing levels, a critical step in enhancing patient safety and care quality. However, during the end of the 2023 legislative session, Mayo Clinic Health System told state legislators, the Governor, and our US Senators that their staffing software that ensures safe patient care is prioritized in their facility and KNABA was unnecessary. They also claimed having nurse and healthcare worker voices at the table to help determine staffing levels in their units was antiquated. Their software knows better than direct care registered nurses.
As KNABA passed through committees and the House and Senate floors, Mayo escalated their tactics and, at the height of desperation, sent an email to legislators and the Governor stating that if they didn’t kill KNABA and the Healthcare Affordability Board legislation, Mayo would pull a $4 billion dollar investment from Rochester. This ultimately led to the staffing committees and anti-retaliation language dying and the legislature passing only sections of our bill in a new act.
Nurses keep telling elected officials that decisions made by healthcare systems like Mayo Clinic Health System not only affect patients but also have a profound impact on nurses. This report clearly shows the damage done by these decisions when Mayo Rochester alone accounts for over 10% of all adverse events in the state, including one patient death.
High nurse-to-patient staffing ratios put immense pressure on nursing staff, leading to unsafe assignments, moral injury, trauma, increased stress, and decreased job satisfaction. Nurses find themselves in an untenable situation, torn between their commitment to patient care and the constraints imposed by profit-driven decisions. Instead of recognizing the importance of including the nurse voice in staffing committees, Mayo fought against important legislation that would have been helpful in retaining nurses and improving patient care.
Mayo Clinic Health System’s high number of adverse health events cast a shadow on its reputation. It’s important to share this information so there can be accountability. You can share this information and hold Mayo Clinic and other healthcare giants accountable by taking action. Come to the Minnesota Capitol and tell legislators that it is far past time for them to listen to nurses and help prevent unnecessary patient harm and death; engage in the political process and tell your stories; and stand together in solidarity to call for the end of profit-driven healthcare decisions. Politics is how we care for one another–it’s an important way to make meaningful change inside hospitals and at the bedside.
This is really important information. I worry that calling “ High nurse-to-patient staffing” the problem is confusing. It’s a high PATIENT to nurse ratio that is problematic (I.e. 60 patients to one nurse is bad and 5 patients to one nurse is good). A high NURSE to patient ratio would be great (I.e. 5 nurses for 20 patients good where 5 nurses to 60 patients is bad).