The Role Of Nurses In Improving Hospital Quality And Efficiency: Real-World Results

Department of Health Services, School of Public Health, University of California, Los Angeles, CA, USA.
Health Affairs (Impact Factor: 4.97). 07/2009; 28(4):w625-33. DOI: 10.1377/hlthaff.28.4.w625
Source: PubMed


Discussions of hospital quality, efficiency, and nursing care often taken place independent of one another. Activities to assure the adequacy and performance of hospital nursing, improve quality, and achieve effective control of hospital costs need to be harmonized. Nurses are critical to the delivery of high-quality, efficient care. Lessons from Magnet program hospitals and hospitals implementing front-line staff-driven performance improvement programs such as Transforming Care at the Bedside illustrate how nurses and staff, supported by leadership, can be actively involved in improving both the quality and the efficiency of hospital care.

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    • "Surveys of hospital nurses from 12 European countries and the United States showed that these countries face challenges related to patient care quality, safety and nurses' burnout and dissatisfaction (Aiken et al. 2012). Nurses' commitment to both clients and institutions is essential because nurses are the largest group of hospital workers and play a crucial role in patient quality of care and safety, in addition to hospital cost management (Needleman & Hassmiller 2009). As a profession, nursing requires high interpersonal contact and strong relational skills related to their contact with and impact on beneficiaries' lives (Grant 2007, Grant & Parker 2009). "
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    ABSTRACT: Aim: This paper studies work engagement as a mediator of the associations between relational job characteristics and nurses' affective commitment to the hospital. Background: Previous research has shown that work engagement mediates the relationship between job resources and affective organizational commitment. However, relational job characteristics, which may be job resources, have not been studied or examined in relation to work engagement and affective organizational commitment in the nursing profession. Method: Data for this correlational study were collected by survey over a 3-month period (2013) from a sample of 335 hospital nurses. Measures included Portuguese translations of the Relational Job Characteristics' Psychological Effects Scale, the Work Engagement Scale, and the Affective Organizational Commitment Scale. Results: Data analysis supported a full mediation model, in which relational job characteristics explained affective commitment to the hospital through nurses' work engagement. Conclusions: Relational job characteristics may contribute to nurses' work engagement, which, in turn, contributes to affective organizational commitment.
    Journal of Advanced Nursing 09/2015; DOI:10.1111/jan.12834 · 1.74 Impact Factor
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    • "Reviews of hospitals and nursing units participating in the TCAB program showed that a large number of innovations were suggested, adopted, and spread, resulting in patient care improvements and high vitality and teamwork among staff (Needleman et al., 2009; Pearson et al., 2009). The TCAB program represents a powerful mechanism for improving the human capital of a health care organization (Dearmon et al., 2013). "
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    ABSTRACT: Background: The Transforming Care at the Bedside (TCAB) project engages frontline health care providers as the leaders of change and improvement efforts in their work environment. This study explored how health care providers and managers from three TCAB units in a university-affiliated health care center perceived the development of their change capacities following their involvement in this program. Method: This descriptive, qualitative study involved focus groups and individual interviews. Results: Participants learned to work as a team and to expand their outlook. They had access to processes and tools to learn new skills. New relationships also developed among the various players, and they shared new roles, which enabled them to translate the desired changes into action and make the results visible. Conclusion: The study showed the TCAB program helps develop health care providers' and managers' change capacities.
    The Journal of Continuing Education in Nursing 10/2014; 45(11):1-7. DOI:10.3928/00220124-20141023-02 · 0.52 Impact Factor
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    • "Effective and gratifying work—the satisfaction that comes from providing good quality care to patients—becomes less attainable. Although hiring more nurses can be costly, some of these costs would be offset by increased productivity , a reduction in turnover and retraining costs, and, more importantly, better patient outcomes (Dall, Chen, Seifert, Maddox, & Hogan, 2009; Jones, 2004; Needleman & Hassmiller, 2009; Rothberg, Abraham, Lindenauer, & Rose, 2005). Our intent was not to discount the importance of wage; wages are an important tool for administrators to use to attract and expand their workforce (Buerhaus, 2008). "
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    ABSTRACT: Research has shown that hospitals with better nurse staffing and work environments have better nurse outcomes-less burnout, job dissatisfaction, and intention to leave the job. Many studies, however, have not accounted for wage effects, which may confound findings. By using a secondary analysis with cross-sectional administrative data and a four-state survey of nurses, we investigated how wage, work environment, and staffing were associated with nurse outcomes. Logistic regression models, with and without wage, were used to estimate the effects of work environment and staffing on burnout, job dissatisfaction, and intent to leave. We discovered that wage was associated with job dissatisfaction and intent to leave but had little influence on burnout, while work environment and average patient-to-nurse ratio still have considerable effects on nurse outcomes. Wage is important for good nurse outcomes, but it does not diminish the significant influence of work environment and staffing on nurse outcomes.
    Policy Politics &amp Nursing Practice 08/2014; 15(3-4). DOI:10.1177/1527154414546868
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