The Overtime Myth That is Hurting Healthcare

It’s no secret that reducing overtime can reduce labor costs. In a recent Health Leaders survey of healthcare executives, overtime was ranked as the top workforce management initiative for labor cost reduction.

But, in that same survey, less than ¼ of respondents ranked overtime in their top three workforce management initiatives for successful quality of care improvements. What’s the implication of that line of thinking? If the budget can bear it, reducing overtime does not need to be a priority. That is a myth.

While overtime has an enormous impact on the bottom line, it has an equally important impact on patient outcomes. A growing body of research has revealed the following:

  • Nurses working a shift longer than 12.5 consecutive hours are more than twice as likely to make an error[i]
  • The risk of a medication error or hospital-acquired infection is more than tripled when nurses work more than 40 hours per week[ii]
  • A patient fall or pressure ulcer is more than three times more likely when nurses work voluntary overtime[iii]

Research has shown that the cost of overtime cuts far deeper than the bottom line. While the need for labor cost reductions is often the driving force behind an initiative to reduce overtime, it’s dangerous to overlook how overtime impacts quality of care and patient outcomes. Even when the budget can absorb overtime costs, the risk to quality of care makes the reduction of overtime a priority that cannot be ignored.


[i] Rogers, Ann, et al. The Working Hours Of Hospital Staff Nurses And Patient Safety. Health Affairs, 23, no.4 (2004):202-212.

[ii] Bae, Sung-Heui. Presence of Nurse Mandatory Overtime Regulations and Nurse And Patient Outcomes. Nursing Economics. March/April 2013; 31, no. 2: 59-89.

[iii] Ibid.


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