Work environment factors other than staffing associated with nurses’ ratings of patient care quality

Abstract

Our evidence demonstrates the importance of considering RN work environment factors other than staffing when planning improvements in patient care quality. Health care managers can use the results of our study to strategically allocate resources toward work environment factors that have the potential to improve quality of care.

Shared Vision Among Acute Care Magnet® Hospital Nurses

“…Possible reasons might be that the Magnet® hospitals have a common set of desirable organizational attributes, which include: decentralization of decision making to the level of the nursing unit; strong, effective and visible nursing leadership; recognition of professional nurse autonomy, accountability, and responsibility for quality patient care; and adequate staffing and flexible scheduling (Djukic et al, 2013;Kelly, McHugh, & Aiken, 2011;Stimpfel et al, 2014). As was reported in prior research of Magnet® hospitals, a high level of shared vision among multi-disciplinary healthcare providers is more likely to promote quality of nursing care and result in desirable patient outcomes (i.e., higher patient satisfaction and lower mortality) (McHugh et al, 2013;Yang et al, 2013).…”

“…Staff nurses may have different perspectives from nurse executives with regard to shared vision and the locations and types of hospitals in which nursing staff work may influence nurses' responses. Comparatively, Magnet® hospitals have attributes of good work environments that nurses find essential to quality care and are thus able to successfully recruit and retain professional nurses despite a national nursing shortage of nursing workforce (Djukic et al, 2013;Stimpfel, Rosen, & McHugh, 2014). The level of shared vision as well as the psychometric performance of the SV scale might be different between Magnet® hospital nurses who provide direct patient care and rural hospital nursing executives who oversee nursing workforce and function administratively.…”

“…Higher shared vision among health clinicians is associated with better work environments that enhance care process and quality (Newhouse et al, 2009). Organizational and multi-disciplinary efforts are needed to foster shared vision by promoting common patient-centered goals and philosophies, and building a mutual decisionmaking and interdisciplinary teamwork climate (Djukic, Kovner, Brewer, Fatehi, & Cline, 2013).…”

Intensive care unit organisation and nurse outcomes: A cross-sectional study of traditional and “hot-floor” structures

“…Additionally for the hot-floor, approximately 13% more nurses intended to resign within 12-months and this was associated with a higher level of reported depersonalisation potentially due to the larger clinical workforce reducing the sense of cohesion. [22,66] Disconnected, or isolated, nurses experience poor collegial communication and increased emotional fatigue that manifests as an unfeeling, impersonal or callous response toward patients, family and colleagues. [23,67,68] Up to 48% of critical care nurses have been found to experience depersonalisation, the subsequent professional and social isolation of which may hinder participation, undermine teamwork and compound burnout.…”

A qualitative study of the work environment in obstetrical nursing in northeastern Ontario, Canada

“…[6] Improving patient care quality and health services delivery include approaches that improve nurses work environment. [7] Examining nurses' work environment (e.g., setting where nurses work) and ways to retain and recruit new workers is critical. This is because the workforce in Canada will need an additional 60,000 full-time equivalent RNs by 2022.…”