S3Ri Health Services Research Impact

A project (lead by Professor Peter Griffiths) to investigate the links between nurse staffing levels and patient care outcomes in hospitals which involved S3Ri members is proving to be highly influential.

The study funded by the National Institute for Health Research’s Health Services and Delivery Research programme investigated associations between nurse staffing levels, missed vital signs observations and the risk of dying in hospital . The project addressed a number of important limitations in evidence that were identified by NICE when it reviewed evidence for safe staffing guidance following the Francis enquiry in 2014. Using individual patient level exposures of variation in staffing levels and electronic records of vital signs observations, the study made considerable advances on previous research on nurse staffing, which had relied on hospital level cross-sectional associations to estimate possible consequences of low staffing. By exploring the possible role of monitoring of patients vital signs, the study also shed light on possible causal mechanisms.

The study has resulted in a number of publications which have resulted in widespread discussion on social media and in policy circles. Using the Altmetrics score as an overview of online attention, the project report is the most highly ranked issue of the Health Services and Delivery Research Journal and other publications from the project also rank amongst the most highly talked about papers across a range of journals including BMJ Quality and Safety where was chosen by the editors as top paper of the year in 2019, achieving an Altmetric score of 802 . Outputs from the study have been cited in policy discussion across the world including recent reports from the National Audit Office ,  the Belgium Knowledge Centre (equivalent to NICE) and WHO .