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  1. Hodge, Margaret Blakeman EdD, RN
  2. Asch, Steven M. MD, MPH
  3. Olson, Valerie A. BA
  4. Kravitz, Richard L. MD
  5. Sauve, Mary Jane DNSc, RN


Concerns about the adequacy of patient care and safety in the state of California led to legislation that required the implementation of mandatory nurse staffing ratios. The authors describe a novel approach for identifying indicators that could be used to evaluate the impact of these regulations on quality of care and patient outcomes. The results of this project demonstrate that this is a useful method for identifying indicators appropriate for use in outcomes research with a focus on structural predictors of quality in healthcare.