Nursing Leadership manages the largest and most expensive labor force in the hospital. When there is negative balance in reimbursements; the finance department looks to nursing to balance the books by decreasing labor costs. Nursing will be expected to freeze hiring, cancel contracts and ultimately eliminate positions. 

When nursing staff is downsized, the environment places your staff at risk for making errors resulting in potential harm to the patient population. The errors will impact on the quality metrics that are reported resulting in more deficits to the bottom line.

HQM consulting recommends a strategy that is inclusive of the entire medical team. 


"Root cause analysis (RCA) is a structured method used to analyze serious adverse events. Initially developed to analyze industrial accidents, RCA is now widely deployed as an error analysis tool in health care. A central tenet of RCA is to identify underlying problems that increase the likelihood of errors while avoiding the trap of focusing on mistakes by individuals." (PSN,N.D.2014,para.2)

What are next steps?

HQM consulting employs the basic tenets of RCA and through this process we can uncover the underlying problem(s) and provide solutions to prevent the errors from occurring again. This may include new processes, new workflows, and or automation. These solutions may require additional training/education for the team to undertake. HQM consulting supports investing in the team so they can have the resources to be successful. A successful healthcare delivery team directing impacts in quality outcomes resulting in increased reimbursements.


Root Cause Analysis. (n.d.). Retrieved January 5, 2019, from


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