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United States

 The RN4CAST-US Study examines organizational-level changes over time in nurse inputs in education, staffing, skill mix, and work environment between the nurse survey projects carried out first in 1999, repeated in 2006 and 2015. 

Panel Study of Effects of Changes in Nursing on Patient Outcomes

With funding from the National Institute of Health, CHOPR investigators developed an efficient, innovative extension of the earlier survey, thus creating a larger study of the impact of change.

Linda H. Aiken, PhD, RN, FAAN, RN4CAST-US Study DirectorLinda H. Aiken, PhD, RN, FAAN, RN4CAST-US Study Director

“The great strength of this project is that in creating a panel of organizational observations, we can see where change has occurred and why.”

Our Research Team

Dr. Linda H. Aiken is among the most respected health services researchers in the world having received virtually all of the research honors in her field. She is a nurse and a sociologist and holds an endowed professorship at the University of Pennsylvania in nursing and sociology. 

Dr. Jeannie Cimiotti research interests focus on the health care workforce and the quality of patient care. She is internationally known for managing and evaluating large-scale research projects that examine nurse workforce issues. 

Dr. Olga Jarrín’s work has focused on how to improve our health care system for older adults and people of all ages living with chronic illness and disabilities. She believes that the best outcomes for patients are achieved when policies are in place that ensure health care professionals have the resources and support systems needed to provide essential patient care.

Dr. Ann Kutney-Lee’s research is focused on the effects of nursing care organization on patient outcomes, redesigned systems that can work more efficiently to provide equitable and high-quality patient care, and the adoption of technological innovations (e.g. electronic health records) and how they are correlated to patient outcomes.

Dr. Patricia A. Grady, Director, National Institute of Nursing Resarch (retired)Dr. Patricia A. Grady, Director, National Institute of Nursing Resarch (retired)

“Dr. Aiken is a visionary whose innovative work continues to increase nursing science’s impact on policy and practice across America and around the world.” 


Dr. Matthew D. McHugh draws on his expertise in nursing, law, public health, and health services research to conduct studies demonstrating nursing’s position as a force for quality, equity, and innovation in health services.  His work has advanced the field of nursing outcomes and policy research by showing the value of investing in nursing as a vehicle to achieve a higher functioning health care system.

Dr. Douglas Sloane has contributed to the design of over 60 research studies and the analysis of the data resulting from them, using a diversity of methods ranging from standard and robust linear and logistic regression procedures to loglinear models and mixed-level models and survival methods and time-series models

Dr. Herbert L. Smith has been involved in the study of the organizational aspects of hospital nursing, and their implication for the well-being of patients and nurses alike, for over 25 years. Professor Smith’s contributions focus on measurement, research design, and data analysis. 

The IRB number for this study is 819470. It has been approved by the University of Pennsylvania’s IRB and follows all federal and state requirements for the protection of human subjects.