Operational efficiency in hospitals — the streamlining of staffing, workflows, and resource use — is essential to delivering safe and high-quality care.
Taryn M. Edwards, M.S.N., APRN, NNP-BC
President, National Association of Neonatal Nurses
At its core, operational efficiency helps reduce delays, minimize risks, and improve patient safety. Nowhere is this more critical than in neonatal intensive care units (NICUs), where even small disruptions can affect outcomes for the most fragile patients. From preventing infections to reducing medical errors, efficient operations are directly linked to patient safety and nurse effectiveness.
In NICUs, nurse-to-patient ratios and timely task completion are directly tied to patient safety. Studies show that many U.S. NICUs regularly fall short of national staffing recommendations, particularly for high-acuity infants. These shortfalls are linked to increased infection rates and higher mortality among very low-birth-weight babies, some experiencing a nearly 40% greater risk of hospital-associated infections due to inadequate staffing.1,2
In such high-stakes environments, missed care isn’t just a workflow issue; it’s a safety hazard. Neonatal nurses manage hundreds of tasks per shift, including medication administration, monitoring, and family education. When units are understaffed or systems are inefficient, essential safety checks can be delayed or missed. In fact, up to 40% of NICU nurses report regularly omitting care tasks due to time constraints.
Improving NICU care
Efficient operational systems support safety in tangible ways. Structured communication protocols, such as standardized discharge checklists and safety huddles, reduce handoff errors and ensure continuity of care. One NICU improved its early discharge rate from just 9% to over 50% using such tools, enhancing caregiver readiness and parental satisfaction while decreasing length of stay.3
Work environments also matter. NICUs with strong professional nursing cultures and transparent data-sharing practices report fewer safety events and higher overall care quality. Nurses in these units are up to 80% less likely to report poor safety conditions, even when controlling for staffing levels.4
Finally, operational efficiency safeguards nurses themselves. By reducing unnecessary interruptions and missed tasks, it protects against burnout, a key contributor to turnover and medical error. Retaining experienced neonatal nurses is itself a vital safety strategy, ensuring continuity of care and institutional knowledge.
Ultimately, operational efficiency is a foundation for patient safety, clinical excellence, and workforce sustainability. For neonatal nurses, it creates the conditions to provide thorough, attentive care. For the tiniest patients, it can mean shorter stays, fewer complications, and stronger chances for a healthy start.
References:
1. Feldman K, Rohan AJ. Data-driven nurse staffing in the neonatal intensive care unit. MCN Am J Matern Child Nurs. 2022;47(5):249-264. doi: 10.1097/NMC.0000000000000839. PMID: 35960217.
2. Rogowski JA, Staiger D, Patrick T, Horbar J, Kenny M, Lake ET. Nurse staffing and NICU infection rates. JAMA Pediatr. 2013;167(5):444–450. doi:10.1001/jamapediatrics.2013.18
3. Kaemingk BD, Hobbs CA, Streeton AC, Morgan K, Schuning VS, Melhouse JK, Fang JL. Improving the timeliness and efficiency of discharge from the NICU. Pediatrics. 2022;149(5):e2021052759. doi: 10.1542/peds.2021-052759. PMID: 35490280.
4. Lake ET, Hallowell SG, Kutney-Lee A, Hatfield LA, Del Guidice M, Boxer BA, Ellis LN, Verica L, Aiken LH. Higher quality of care and patient safety associated with better NICU work environments. J Nurs Care Qual. 2016;31(1):24-32. doi: 10.1097/NCQ.0000000000000146. PMID: 26262450; PMCID: PMC4659734.
