Article

Exploring the Impact of Staff Absenteeism on Patient Satisfaction Using Routine Databases in a University Hospital.

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Abstract

To explore the influence of staff absenteeism on patient satisfaction using the indicators available in management reports. Among factors explaining patient satisfaction, human resource indicators have been studied widely in terms of burnout or job satisfaction, but there have not been many studies related to absenteeism indicators. A multilevel analysis was conducted using two routinely compiled databases from 2010 in the clinical departments of a university hospital (France). The staff database monitored absenteeism for short-term medical reasons (5 days or less), non-medical reasons and absences starting at the weekend. The patient satisfaction database was established at the time of discharge. Patient satisfaction related to relationships with staff was significantly and negatively correlated with nurse absenteeism for non-medical reasons (P < 0.05) and with nurse absenteeism starting at weekends (P < 0.05). Patient satisfaction related to the hospital environment was significantly and negatively correlated with nurse assistant absenteeism for short-term medical reasons (P < 0.05). Our findings seem to indicate that patient satisfaction is linked to staff absenteeism and should lead to a better understanding of the impact of human resources on patient satisfaction. To enhance patient satisfaction, managers need to find a way to reduce staff absenteeism, in order to avoid burnout and to improve the atmosphere in the workplace.

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... These findings have also been replicated within the healthcare setting, with nurse job satisfaction being found to impact on patient satisfaction (Newman and Maylor, 2002;Mrayyan, 2006;Kvist et al., 2014) and quality of care (Robertson et al., 1995;Newman and Maylor, 2002). Furthermore, a direct link has also been established between healthcare worker absenteeism and patient satisfaction (Duclay et al., 2015). As such, the Granger causality relationships between performance in 'staff sick leave rate' and performance in the measures contained in the Process and Efficiency and Patient and Quality perspectives appear reasonable and are supported by empirical research. ...
... Evidence is emerging that workplace safety also impacts customer satisfaction (Willis et al., 2012), a finding we confirm with the 'workplace injury rate' impacting on 'patient satisfaction rate'. This relationship also makes sense given the research supporting the effect of healthcare worker absenteeism on patient satisfaction (Duclay et al., 2015). It is also unsurprising that workplace injury rates may affect the 'percentage of complaints resolved/closed': when the incidence of workplace injuries increases, it is likely to put pressure on other staff so non-critical functions, such as investigating and resolving complaints, are less likely to take precedence over patient-focused tasks. ...
... We find evidence of most of the causal relationships expected by the project team that developed the District Health Boards BSC. We also confirm relationships between performance measures previously found within the management, healthcare and safety literatures, e.g., that workplace injury rates and staff sick leave are both associated with patient satisfaction and hospital financial performance (Koys, 2001;Newman and Maylor, 2002;Harter et al., 2002aHarter et al., , 2002bHomburg and Stock, 2004;Mrayyan, 2006;Fern andez-Muñiz et al., 2009;Willis et al., 2012;Kvist et al., 2014;Duclay et al., 2015;Haupt and Pillay, 2016). This provides evidence for the BSC's potential to operationalise strategy and inform performance management within a public sector setting. ...
Article
The existence and nature of underlying cause-and-effect relationships is an emerging issue in studies of Balanced Scorecard (BSC) performance measurement models. Notably, Malina et al. (2007) recently extended the debate surrounding BSC cause-and-effect relationships via their examination of a BSC model used by a Fortune 500 company. Finding only limited support for any cause-and-effect relationships within this BSC, Malina et al. (2007, p. 974) concluded that cause-and-effect validity, in some contexts at least, might be less important to BSC effectiveness than previously expected. However, their study has several limitations (discussed later), meaning that additional studies - using comprehensive, multi-period databases of BSC measures and rigorous statistical analysis - are needed to progress our understanding in this area. This paper draws on a unique, multi-period database of seventeen BSC performance measures to examine the empirical evidence for cause-and-effect relationships in a public sector BSC performance management model. In so doing, it addresses two key gaps in the extant literature: (i) the dearth of rigorous longitudinal tests of BSC cause and effect relationships and (ii) the absence of empirical research into the structure of BSCs applied in public sector contexts. It also addresses many of the limitations of Malina et al. (2007) and other key studies. The findings suggest that expected cause-and-effect relationships are not consistently present in the NZ hospitals BSC. This draws into question the efficacy of this BSC as a strategic management tool to support hospital performance improvement. However, it also points to the potential importance of other issues emerging in the literature concerning the nature and necessity of cause-and-effect relationships in BSC models, particularly in their public sector application.
... and competent personnel to perform tasks safely, predisposing organisations to poor performance and high costs (Gaudine et al., 2013). Duclay, Hardouin, Sébille, Anthoine, and Moret (2015) indicate that a shortage of personnel affects the safety and quality of patient care with remaining staff having limited time to satisfactorily perform extra tasks. Duclay et al. (2015) attest that having fewer HCWs means that those workers at work assume an excessive workload, causing an imbalance in their health, resulting in a pathological cycle of absenteeism in the institution. ...
... Duclay, Hardouin, Sébille, Anthoine, and Moret (2015) indicate that a shortage of personnel affects the safety and quality of patient care with remaining staff having limited time to satisfactorily perform extra tasks. Duclay et al. (2015) attest that having fewer HCWs means that those workers at work assume an excessive workload, causing an imbalance in their health, resulting in a pathological cycle of absenteeism in the institution. Absenteeism results in productivity losses from altered resource allocation decisions (Zhang, Sun, Woodcock, & Anis, 2017). ...
... Fagerström and Vainikainen (2014) argue that absenteeism stems from workload issues where there is a connection between work requirements and its physical effects. Work burdens can be physical, perceptual, subjective, social, and hierarchical (Fagerström & Vainikainen, 2014), and where HCW are working long hours exerting physical effort and/or in uncomfortable positions, absence rates have been high (Duclay et al., 2015;Ha, 2015;Mudaly & Nkosi, 2015). ...
Article
Aim To explore absenteeism trends and absenteeism management from the perspective of nurse unit managers. Background Unscheduled absenteeism among nurses appears to be a multi‐factorial phenomenon and is a source of concern due to the effect absenteeism has on the daily management of human resources, ultimately affecting delivery of safe care. Identifying absenteeism trends among nurses may inform the development of targeted strategies to minimize unscheduled absenteeism. Methods A mixed‐methods approach was used with the quantitative phase retrospectively reviewing and analysing nurse absenteeism data, whilst the qualitative phase involved semi‐structured interviews with nurse unit managers, exploring their perceptions pertaining to the absenteeism trends. Results Data analysis revealed that absenteeism in hospitals follows various trends, amongst them seasonal, daily, and demographic trends. A heavy workload, which takes its toll on the nurses’ physical and mental health, also contributes to nurse absenteeism. Conclusion This study reveals absenteeism trends from nurse managers’ perspectives, with authentication from official statistics. Any prescriptive measures for absenteeism should take into account absenteeism trend analysis and the work environment. Implications for Nursing Management An analysis of absenteeism trends will assist management in initiating tailor‐made intervention measures.
... These findings have also been replicated within the healthcare setting, with nurse job satisfaction being found to impact on patient satisfaction (Newman and Maylor, 2002;Mrayyan, 2006;Kvist et al., 2014) and quality of care (Robertson et al., 1995;Newman and Maylor, 2002). Furthermore, a direct link has also been established between healthcare worker absenteeism and patient satisfaction (Duclay et al., 2015). As such, the Granger causality relationships between performance in 'staff sick leave rate' and performance in the measures contained in the Process and Efficiency and Patient and Quality perspectives appear reasonable and are supported by empirical research. ...
... Evidence is emerging that workplace safety also impacts customer satisfaction (Willis et al., 2012), a finding we confirm with the 'workplace injury rate' impacting on 'patient satisfaction rate'. This relationship also makes sense given the research supporting the effect of healthcare worker absenteeism on patient satisfaction (Duclay et al., 2015). It is also unsurprising that workplace injury rates may affect the 'percentage of complaints resolved/closed': when the incidence of workplace injuries increases, it is likely to put pressure on other staff so non-critical functions, such as investigating and resolving complaints, are less likely to take precedence over patient-focused tasks. ...
... We find evidence of most of the causal relationships expected by the project team that developed the District Health Boards BSC. We also confirm relationships between performance measures previously found within the management, healthcare and safety literatures, e.g., that workplace injury rates and staff sick leave are both associated with patient satisfaction and hospital financial performance (Koys, 2001;Newman and Maylor, 2002;Harter et al., 2002aHarter et al., , 2002bHomburg and Stock, 2004;Mrayyan, 2006;Fern andez-Muñiz et al., 2009;Willis et al., 2012;Kvist et al., 2014;Duclay et al., 2015;Haupt and Pillay, 2016). This provides evidence for the BSC's potential to operationalise strategy and inform performance management within a public sector setting. ...
Article
According to Kaplan and Norton, a fundamental tenet of the balanced scorecard (BSC) is that cause‐and‐effect relationships exist across measures within its four perspectives. However, prior research on BSCs has provided equivocal findings as to whether these relationships exist. Using a public sector BSC, we conduct a panel Granger causality analysis and find evidence of causal relationships. We highlight the importance of this finding from both a research and practice perspective.
... Thus, to study the association of work stress and unplanned absenteeism among nurses, of whom the majority are female, the duration of MC or EL needs to be analyzed too. Duclay et al. (2015) found that having less healthcare personnel present at work due to absenteeism would mean that those workers left at work assumed an excessive workload, which caused an imbalance in their health and resulted in a pathological cycle of absenteeism within the institution [23]. A qualitative study found that in addition to the inadequate staffing and workload, absenteeism added pressure during work hours that led to job dissatisfaction [24]. ...
... Thus, to study the association of work stress and unplanned absenteeism among nurses, of whom the majority are female, the duration of MC or EL needs to be analyzed too. Duclay et al. (2015) found that having less healthcare personnel present at work due to absenteeism would mean that those workers left at work assumed an excessive workload, which caused an imbalance in their health and resulted in a pathological cycle of absenteeism within the institution [23]. A qualitative study found that in addition to the inadequate staffing and workload, absenteeism added pressure during work hours that led to job dissatisfaction [24]. ...
Article
Full-text available
Unplanned absenteeism (UA), which includes medically certified leave (MC) or emergency leave (EL), among nurses may disturb the work performance of their team and disrupt the quality of patient care. Currently, there is limited study in Malaysia that examines the role of stressors in determining absenteeism among nurses. Therefore, apart from estimating the prevalence and the reasons of UA among nurses in Malaysia, this study aims to determine its stressor-related determinants. A cross-sectional study was conducted among 697 randomly sampled nurses working in Selangor, Malaysia. Most of them were female (97.3%), married (83.4%), and working in shifts (64.4%) in hospital settings (64.3%). In the past year, the prevalence of ever taking MC and EL were 49.1% and 48.4%, respectively. The mean frequency of MC and EL were 1.80 (SD = 1.593) and 1.92 (SD = 1.272) times, respectively. Meanwhile, the mean duration of MC and EL were 4.24 (SD = 10.355) and 2.39 (SD = 1.966) days, respectively. The most common reason for MC and EL was unspecified fever (39.2%) and child sickness (51.9%), respectively. The stressor-related determinants of durations of MC were inadequate preparation at the workplace (Adj.b = −1.065) and conflict with doctors (adjusted regression coefficient (Adj.b) = 0.491). On the other hand, the stressor-related determinants of durations of EL were conflict with spouse (Adj.b = 0.536), sexual conflict (Adj.b = −0.435), no babysitter (Adj.b = 0.440), inadequate preparation at workplace (Adj.b = 0.257), lack of staff support (Adj.b = −0.190) and conflict with doctors (Adj.b = −0.112). The stressor-related determinants of the frequency of MC were conflicts over household tasks (Adj.b = −0.261), no time with family (Adj.b = 0.257), dangerous surroundings (Adj.b = 0.734), conflict with close friends (Adj.b = −0.467), and death and dying (Adj.b = 0.051). In contrast, the stressor-related determinants of frequency of EL were not enough money (Adj.b = −0.334), conflicts with spouse (Adj.b = 0.383), pressure from relatives (Adj.b = 0.207), and inadequate preparation (Adj.b = 0.090). In conclusion, apart from the considerably high prevalence of unplanned absenteeism and its varying frequency, duration and reasons, there is no clear distinction in the role between workplace and non-workplace stressors in determining MC or EL among nurses in Malaysia; thus, preventive measures that target both type of stressors are warranted. Future studies should consider longitudinal design and mixed-method approaches using a comprehensive model of absenteeism.
... In the hospital routine, the nursing team encounters different situations such as fear, power relations, conflicts, long working hours, anxiety, stress, living with life and death, and tensions among many others. Given this scenario, it is indispensable that managers understand the work of nursing teams in an expanded way, considering the different aspects involved in the provision of care and the physical and mental health of all his collaborators (16) . ...
... Even in adverse situations, the professionals realize that they can build something positive; they can improve, either individually or collectively. The work also provides moments of satisfaction because, at work, the human being builds a life and inserts himself in the world not only as a way of surviving but also for personal and professional fulfillment (16) . ...
Article
Full-text available
Objetivo: Analisar as percep��es dos t�cnicos de enfermagem de um hospital de pequeno porte sobre o remanejamento entre setores. M�todo: Pesquisa descritiva, com abordagem qualitativa, em que os dados foram coletados por meio de entrevistas com trinta t�cnicos de enfermagem, utilizando-se o m�todo de satura��o. O material foi analisado a partir da an�lise de conte�do proposta por Bardin. Resultados: Os resultados apontaram que o remanejamento � considerado, pelos colaboradores, uma situa��o eventual e necess�ria � rotina de trabalho. Entretanto, pode-se observar que causa desconforto � equipe e que deve ser realizado com crit�rios que n�o impactem no processo de trabalho dos envolvidos. Os pontos negativos elencados pelos colaboradores, neste processo, foram a sobrecarga de trabalho e a mudan�a de setor, entretanto os mesmos citaram a possibilidade de aprendizado e aperfei�oamento profissional, como pontos positivos do remanejamento. Conclus�o: O remanejamento � percebido como parte da rotina pelos profissionais, sendo necess�rio um investimento, por parte da gest�o, para prevenir situa��es de desconforto e desarranjos que impactem na sa�de ocupacional de seus colaboradores bem como na qualidade da assist�ncia de seus pacientes.
... Similarly, the absence of literature has offered diverse analysis towards providing explanations to the conundrum of absenteeism in the workplace. To be sure, a large chunk of these studies have identified absenteeism as a bane for organisational performance (Sigh & Karodia, 2016), the impact of job satisfaction on absenteeism (Kehinde, 2011), and impact of staff absenteeism on patients satisfaction (Ducklay et al., 2014). However, what remains largely unknown is the tie between work environmental factors and employees absenteeism. ...
... Traditionally, the affective well-being discourse portends essential consequences for employees work performance. For instance, extant studies on the psychology of well-being are increasingly recognising the role of affective well-being as a precursor to organisational growth (Ducklay et al., 2014;Madden, 2009). Therefore, the contention about affective well-being has established that work situation and the processes of adjustment are crucial indicators of negative affective well-being (Zeidner, Matthews & Roberts, 2012). ...
Article
Human resources remain the most important and valuable assets of every organisation. In effect, the strategic monitoring and management of related environmental factors and employees’ affective well-being for continued presence at work are becoming increasingly fundamental. The mining industry is characterised with different environmental factors and affective well-being puzzle that may likely affect employees’ turnaround time at work. While available studies have largely investigated how environmental factors predict employee’s well-being, what is unclear is how environmental factors and affective well-being determines employee’s absenteeism from work. Using a quantitative study, this study examines how environmental factors and affective well-being influence workers absenteeism in South African mine industry. A total of 280 mineworkers were randomly selected using a descriptive survey of the probability sampling technique. The retrieved data were analysed using both the simple and multivariate regression analysis. The findings revealed that both environmental factors and affective well-being do not predict mine workers absenteeism, although environmental factors show more variation in employee’s absenteeism than affective well-being. Similarly, the different environmental factors including exposure to noise, dust, vibration, temperature and heavy lifting do not show any evidence to have predicted mine workers turnaround time at work, except hazardous materials. The study concludes that mitigating the consequence provoked by hazardous materials on mine workers will significantly increase employees’ presence at work. Thus, the study makes a case for the revitalisation of the South African mining industry, especially in the area of setting out modalities for the control of strenuous environmental factors, particularly hazardous materials in the workplace.
... Absenteeism affects both the psychological and professional well-being of the nurse and the quality of patient care provided as a result of psychological stress, low nursing morale, and increased workload (Mbombi et al., 2018). In the study by Duclay et al. (2015), patient satisfaction in relationships with staff showed a significant and negative correlation with nonmedical reasons and nurse absenteeism that occurred on weekends (Duclay et al., 2015). ...
... Absenteeism affects both the psychological and professional well-being of the nurse and the quality of patient care provided as a result of psychological stress, low nursing morale, and increased workload (Mbombi et al., 2018). In the study by Duclay et al. (2015), patient satisfaction in relationships with staff showed a significant and negative correlation with nonmedical reasons and nurse absenteeism that occurred on weekends (Duclay et al., 2015). ...
Article
Full-text available
Aim This study aimed to determine the tendencies and causes of unplanned absenteeism of nurses and the experiences of clinical nurse managers on this subject. Background Absenteeism is a common way for an employee to distance themselves from their job. Unplanned absence is defined as the employee's inability to come to work without the employer's consent. Methods In the retrospective analysis of the archived data on nurse absenteeism, a qualitative interview technique was used in the data collected from nurse unit managers using the quantitative method, semistructured interview form. Results Children's problems, special reasons, and medical diseases are among the most common reasons for nurses' unplanned absenteeism. As per the nurses in charge, the tendency of unplanned absenteeism in their units is not high; in addition, motivation can reduce the tendency of unplanned absenteeism. Conclusions It was emphasized that in absentee management, interteam communication and regulations aimed at increasing the employee's motivation in the work environment are important. Clinical manager nurses can reduce the frequency of unplanned absenteeism by determining the factors that push nurses working in the clinic to unplanned absenteeism for motivational reasons. This study will guide the preparation of programs to improve the causes of unplanned absences in their clinics.
... This is confirmed by a study conducted by Vivienne and Bamford (2011), stating the factors contributing to people being absent from work. The impact of absenteeism by workers in European healthcare systems has been that of poor patient care satisfaction and increased loss of billions of dollars in the health institutions (Ducklay et al. 2014). In South Africa, absenteeism among nurses is one of the factors causing job dissatisfaction, inevitable increased workload and nurse turnover (Mmamma, Mothiba & Nancy 2015). ...
Article
Full-text available
Background: Absenteeism is a global problem in the working force and this is no exception in the nursing profession. Much attention has been drawn to factors that contribute to absenteeism; however, little attention has been placed on the effects of absenteeism on nurses remaining on duty by their colleagues. Nurses absent themselves leaving behind their colleagues to execute their part of work.Objectives: To investigate the effects of absenteeism on nurses who remained on duty at a tertiary hospital in Limpopo province.Method: A quantitative descriptive research approach was chosen to enable the researchers to achieve the research aim. Data collected using structured questionnaires were analysed by descriptive statistics.Results: The findings indicated that absenteeism has an effect on both the nurses’ psychological and professional well-being, as well as the quality of patient care provided as a result of psychological stress, low morale of nurses and increased workload. The study further revealed the provision of substandard care to patients by those nurses who are remaining on duty, resulting in risk of medical errors that could jeopardise their professional credibility. Therefore, absenteeism creates an unhealthy working environment for nurses remaining on duty.Conclusion: Nurse managers should provide platforms to address psychological and professional problems experienced by nurses remaining on duty. The study further recommends the introduction of policies that would address absenteeism in the workplace and how nurses who remain on duty could be assisted with the workload of colleagues who continuously absent themselves.
... Absenteeism is an important problem for all organizations in that absent employees generally affect many aspects of individual and organizational performance. Employee absenteeism occurs when an employee fails to be present during regular work hours (Duclay et al., 2015). Gregori (2020) found that factors influencing employees' absenteeism morphed into more attitudinal and personal issues during COVID-19. ...
Article
Full-text available
New concerns have emerged during the COVID-19 pandemic that greatly impact employees and many other aspects in organizations. We have highlighted the major organizational issues during COVID-19 and classified the relevant research findings based on 45 recent articles. Main themes identified include (1) work setting, (2) perceptions of COVID-19, (3) employee wellbeing, (4) organizational strategies, and (5) influences on career behaviors. Employees have faced challenges due to work conditions that have shifted from traditional commuting to telework. Employees have also become aware of the negative current situation, so their overall wellbeing has been threatened. In response, organizations have strived to promote positive psychological capital for employees as they attempt to cope with this crisis. Organizations have tried to maintain and manage both their employees and their business. People tended to adjust their career-related behaviors based on how they perceived their own wellbeing and organizational strategies.
... Furthermore, when nurses had worked more than 75% of their shifts as ≥12-hr shifts over the past week, their odds of experiencing both short-term and longterm sickness absence were significantly increased . NHS staff sickness absence is both costly and has negative consequences on patient care (Duclay, Hardouin, Sebille, Anthoine, & Moret, 2015;The Health Foundation, 2015). The negative impact of long shifts on job satisfaction and intention to leave has been reported by a recent European study (Dall'Ora et al., 2015). ...
... Furthermore, when nurses had worked more than 75% of their shifts as ≥12-hr shifts over the past week, their odds of experiencing both short-term and longterm sickness absence were significantly increased . NHS staff sickness absence is both costly and has negative consequences on patient care (Duclay, Hardouin, Sebille, Anthoine, & Moret, 2015;The Health Foundation, 2015). The negative impact of long shifts on job satisfaction and intention to leave has been reported by a recent European study (Dall'Ora et al., 2015). ...
Article
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Aim To evaluate whether ≥12‐hr shifts are associated with a decrease in resource use, in terms of care hours per patient day and staffing costs per patient day. Background Nurses working long shifts may become less productive and no research has investigated whether potential cost savings are realized. Method A retrospective longitudinal study using routinely collected data from 32 wards within an English hospital across 3 years (1 April 2012–31 March 2015). There were 24,005 ward‐days. Hierarchical linear mixed models measured the association between the proportion of ≥12‐hr shifts worked on a ward‐day, care hours per patient day and staffing costs per patient day. Results Compared with days with no ≥12‐hr shifts, days with between 50% and 75% ≥12‐hr shifts had more care hours per patient day and higher costs (estimate for care hours per patient day: 0.32; 95% CI: 0.28–0.36; estimate for staffing costs per patient day: £8.86; 95% CI: 7.59–10.12). Conclusions We did not find reductions in total care hours and costs associated with the use of ≥12‐hr shifts. The reason why mixed shift patterns are associated with increased cost needs further exploration. Implications for Nursing Management Increases in resource use could result in additional costs or loss of productivity for hospitals. Implementation of long shifts should be questioned.
... hitting, assaulting) are high. All these behaviours have a cumulative detrimental impact on patients' care, health and mortality rate(Duclay et al., 2015;Lalonde & Roux-Dufort, 2012;Unruh et al., 2007). ...
Article
Aim The study explores how prevailing absenteeism frustrates or thwarts nurses' and nursing assistants' basic psychological needs (autonomy, competence, and relatedness), using self‐determination theory. Background Our study responds to the call to investigate how organizational characteristics influence employees' psychological need satisfaction and their attitudes and behaviours. Method We conducted a semantic analysis of the discourse of 42 nurses and nursing assistants working in nursing homes for older dependent people in France. Results The analysis subdivides participants' discourse into four themes: short‐term absenteeism, lack of competence, lack of recognition, and work overload. These themes are all linked to participants' perceived deficits or threats concerning their psychological needs. Conclusions The prevailing absenteeism has a harmful spiral impact on nurses' and nursing assistants' attitudes and behaviours, and, ultimately, on the quality of care received by the patients. Implications for Nursing Management Our study confirms the need to adopt various managerial actions to address the following interrelated issues: controlling short‐term absences, reducing work overload, and giving training and recognition.
... Numerous studies reported that employee absence is related to decreased job productivity and important economic costs including in the health care sector. [13][14][15] Further studies are needed for a better understanding of the impact of Hajj-related illness among HCWs. ...
Article
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Background: Data on the risk of transmission of infection to health care workers (HCWs) serving ill pilgrims during the Hajj is scarce. Methods: Two cohorts of HCWs, the first serving Hajj pilgrims in Mecca and the second serving patients in Al-Ahsa, were investigated for respiratory and gastrointestinal symptoms and pathogen carriage using multiplex polymerase chain reaction before and after the 2015 Hajj. Results: A total of 211 HCWs were enrolled of whom 92 were exposed to pilgrims (Mecca cohort), whereas 119 were not exposed (Al-Ahsa cohort). Symptoms were observed only in HCWs from the Mecca cohort, with 29.3% experiencing respiratory symptoms during the Hajj period or in the subsequent days and 3.3% having gastrointestinal symptoms. Acquisition rates of at least 1 respiratory virus were 14.7% in the Mecca cohort and 3.4% in the Al-Ahsa cohort (P = .003). Acquisition rates of at least 1 respiratory bacterium were 11.8% and 18.6% in the Mecca and Al-Ahsa cohorts, respectively (P = .09). Gastrointestinal pathogens were rarely isolated in both cohorts of HCWs and acquisition of pathogens after the Hajj was documented in only a few individuals. Conclusions: HCWs providing care for pilgrims both acquire pathogens and present symptoms (especially respiratory symptoms) more frequently than those not working during Hajj.
... Absenteeism has a triple cost: financial, organizational, and cultural [2]. In hospitals, it can represent a threat to the balance of work teams [3] and can alter the quality of care [4]. Even if there have been several definitions duration of the absence. ...
Article
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Increased absenteeism in health care institutions is a major problem, both economically and health related. Our objectives were to understand the general evolution of absenteeism in a university hospital from 2007 to 2019 and to analyze the professional and sociodemographic factors influencing this issue. An initial exploratory analysis was performed to understand the factors that most influence absences. The data were then transformed into time series to analyze the evolution of absences over time. We performed a temporal principal components analysis (PCA) of the absence proportions to group the factors. We then created profiles with contributions from each variable. We could then observe the curves of these profiles globally but also compare the profiles by period. Finally, a predictive analysis was performed on the data using a VAR model. Over the 13 years of follow-up, there were 1,729,097 absences for 14,443 different workers (73.8% women; 74.6% caregivers). Overall, the number of absences increased logarithmically. The variables contributing most to the typical profile of the highest proportions of absences were having a youngest child between 4 and 10 years old (6.44% of contribution), being aged between 40 and 50 years old (5.47%), being aged between 30 and 40 years old (5.32%), working in the administrative field (4.88%), being tenured (4.87%), being a parent (4.85%), being in a coupled relationship (4.69%), having a child over the age of 11 (4.36%), and being separated (4.29%). The forecasts predict a stagnation in the proportion of absences for the profiles of the most absent factors over the next 5 years including annual peaks. During this study, we looked at the sociodemographic and occupational factors that led to high levels of absenteeism. Being aware of these factors allows health companies to act to reduce absenteeism, which represents real financial and public health threats for hospitals.
... hitting, assaulting) are high. All these behaviours have a cumulative detrimental impact on patients' care, health and mortality rate(Duclay et al., 2015;Lalonde & Roux-Dufort, 2012;Unruh et al., 2007). ...
... Staff will rather use unscheduled time off than report the incident or to work the next time scheduled. Studies have linked unscheduled time off to affect clinical outcomes, the work team, and the organization (Charney & Shimer, 2007;Duclay, Hardouin, Sebille, Anthoine, & Moret, 2014). ...
Article
Introduction: Physical assaults perpetrated by patients in psychiatric hospitals against mental health staff (MHS) is a serious concern facing psychiatric hospitals. Assaulted staff reports physical and psychological trauma that affects their personal and professional lives. There is a dearth of literature exploring this phenomenon. Purpose: To explore MHS perspectives of assault by psychiatric patients. Methods: A transcendental phenomenological qualitative design was used to explore and analyze the perspectives of a purposeful sample of 120 MHS perspectives at an acute inpatient psychiatric hospital. Participants' age ranged from 22 to 63 years (mean age = 32.4). Moustakas' theoretical underpinnings guided the study. Results: Two patterns, 8 themes, and 19 subthemes were identified: (a) Psychological impacts revealed four themes-increase of anxiety/fear level, helplessness and hopelessness, flashbacks/burnout, and doubting own competency. (b) Physiosocial impacts revealed four themes-unsupportive superiors, stigmatization of staff victim, failure to report the incident, and environmental safety. Discussion: Participants verbalized that assaults by patients have instilled fear and trauma in them. Most of the assaults occurred when staff were performing their routine job functions and setting limits to patient's behavior. Conclusion: The study allowed MHS opportunities to narrate their lived experiences of being assaulted by patients and provided validation of their perspectives. Findings illuminated the phenomenon and may help to support policy changes in psychiatric hospitals.
... Estudo realizado em um hospital universitário na França evidenciou que a satisfação do paciente com os serviços prestados era inversamente proporcional ao número de faltas ao trabalho por parte dos enfermeiros, justificando que a ausência desse profissional gera prejuízos para a organização hospitalar e para a assistência ao cliente (36) . ...
Article
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Objectives: to associate pleasure and suffering indicators with aspects related to nursing work in hospitals. Methods: This is a cross-sectional quantitative study conducted with 152 nurses from a university hospital in the city of João Pessoa, Paraíba State, Brazil. Data were collected through interviews, using a tool to obtain sociodemographic data, work characteristics and the Pleasure and Suffering Indicators at Work Scale. Results: pleasure living and its domains were rated as satisfactory, while suffering factors and their domains were critically assessed. Statistically significant associations were observed among pleasure and suffering indicators, and some characteristics of nurses' work. Conclusions: it was evidenced that nurses had critical levels of suffering at work associated with their work practice characteristics.
... A study conducted at a university hospital in France found that patient satisfaction was related to absenteeism due to illness of the nursing staff. (14) Research conducted in the UK found that hospitals with greater numbers of patients per nurses had 26% higher mortality rates than observed in those with a lower patient to nurse ratio. (15) In a study conducted in Brazil, a high patient to nurse ratio was associated with increased incidents of patients falling from beds, central venous catheter infections, absenteeism, staff turnover and low patient satisfaction. ...
Article
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Objective To evaluate the association of absenteeism due to sickness with sociodemographic characteristics and relate it to the work of nursing professionals. Method Descriptive exploratory study that analyzed medical certificates of up to 15 days off work presented by 994 nurses at a university hospital. The data source was the frequency system of the institution. Results Most workers were female, married and technical nurses. The average age was 41.9 years and a third worked in adult inpatient services. Of the 994 professionals, 645 had at least one sick day. Conclusion Absenteeism due to illness is complex and multifactorial. The factors associated with it were: age group, education, function, shift, time in the institution and workplace.
... Organizing work in teams leads to individual sickness absence having consequences for the output of the whole team ( Zhang et al. 2017 ;Heywood et al. 2008 ), which in turn leads to greater productivity loss associated with sickness absence. In addition to productivity loss, total welfare loss includes lower patient satisfaction, which has also been associated with sickness absence in health care ( Duclay et al. 2015 ). ...
Article
Background Participatory working time scheduling is a collaborative approach to scheduling shift work. As a potential way of improving work time control, it may provide a means to reducing sickness absence in shift work. So far, experimental and quasi-experimental studies on the effects of increased work time control on sickness absence are lacking. Objective To investigate the effects of using digital participatory working time scheduling software on ward-level sickness absence among Finnish hospital employees. Participants and methods This quasi-experimental study compared the amount of sickness absence in hospital wards using participatory working time scheduling software (n=121 wards) and those continuing with traditional working time scheduling (n=117 wards) between 2014 and 2017. We used continuous panel data from 238 hospital wards with a total number of 9000 hospital employees (89% of women, primarily nursing staff). The ward-level measures consisted of number of employees, working hours, sickness absence spells per employee, and short (1–3) sickness absence days per employee. Two-way fixed effects and event study regressions with clustered standard errors were used to estimate the effect of using participatory scheduling software on sickness absence. Results Sickness absence spells and short (1–3) sickness absence days decreased by 6% and 7%, respectively in the wards using participatory scheduling compared to those using traditional scheduling. The effect became stronger as the time measured in quarters of using the participatory working time scheduling software increased. Conclusions The effects of using participatory working time scheduling software indicated less ward-level sickness absence measured as spells and days in comparison to continuing with traditional scheduling. The encouraging findings are relevant not only to the health care sector but also to other sectors in which irregular shift work is a necessity. This study was registered with ClinicalTrials.gov (NCT02775331) before starting the intervention phase.
... Em contrapartida, o quantitativo ideal de profissionais incide positivamente sobre os indicadores gerenciais e assistenciais, proporcionando qualidade do cuidado, segurança aos pacientes e profissionais, além de melhorias no ambiente laboral (7)(8) . Assim, o adequado dimensionamento do pessoal de enfermagem torna-se indispensável, pois permite ajustar a equipe às necessidades dos pacientes, além de prevenir a sobrecarga de trabalho (2,9) . ...
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Objective: To identify the nursing team absenteeism rate, calculate the Technical Safety Index and compare them to the percentage established by the Federal Nursing Council. Method: A descriptive, analytical, and retrospective study which included nursing professionals working in a public and tertiary hospital. The Human Resources Department database of the Institution was used for data collection. Absenteeism was considered as any unplanned absence. Results: Ninety-nine (99) professionals participated, of which 21 were nurses and 78 were nursing technicians. Weekly days off prevailed among the expected absences, with 17% for both categories. Maternity leave prevailed among nurses and medical leave among nursing technicians regarding absenteeism, with averages of 12% and 9%, respectively. The Technical Safety Index was 42% for nurses and 38% for nursing technicians. Conclusion: The nursing teams absenteeism rate was 21.5%, while the Technical Safety Index was 40%, thus constituting higher values than those established by the Federal Nursing Council.
... In contrast, the ideal number of professionals positively affects management and care indicators, providing care quality, safety to patients and professionals, and improvements in the work environment (7)(8) . Thus, proper nursing staff sizing becomes indispensable, as it enables adjusting the team to the patients' needs, in addition to preventing work overload (2,9) . ...
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ABSTRACT Objective: To identify the nursing team absenteeism rate, calculate the Technical Safety Index and compare them to the percentage established by the Federal Nursing Council. Method: A descriptive, analytical, and retrospective study which included nursing professionals working in a public and tertiary hospital. The Human Resources Department database of the Institution was used for data collection. Absenteeism was considered as any unplanned absence. Results: Ninety-nine (99) professionals participated, of which 21 were nurses and 78 were nursing technicians. Weekly days off prevailed among the expected absences, with 17% for both categories. Maternity leave prevailed among nurses and medical leave among nursing technicians regarding absenteeism, with averages of 12% and 9%, respectively. The Technical Safety Index was 42% for nurses and 38% for nursing technicians. Conclusion: The nursing team’s absenteeism rate was 21.5%, while the Technical Safety Index was 40%, thus constituting higher values than those established by the Federal Nursing Council.
... Organisations usually incur large costs for the sake of ensuring the continuity of patients' care when absenteeism occurs (Gorman et al. 2010). In addition, it often leads to work overload and a high nurse to patient ratio, which in return compromise patients' outcomes and increase mortality rates (Unruh et al. 2007, Duclay et al. 2014. Nurses' sickness absenteeism also relates to staff satisfaction and turnover (Jalal et al. 2014). ...
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AimTo explore nurses' sickness absenteeism from the perspective of nurse managers.Background Sickness absenteeism among health-care providers, especially nurses, remains a significant problem in an era of challenges to provide high quality care with the required skill mix. This in turn compromises the quality of care and adds to the costs of an organisation.MethodsA qualitative descriptive design was used. Data were collected from a governmental academic hospital in Lebanon. In-depth tape-recorded interviews were conducted with a total of 20 nurse managers. Data were analysed through a content analysis approach.ResultsData analysis yielded three domains as follows: work-related, individual and organisational factors that lead to nurses' sickness absenteeism.Conclusion This study conceptualised nurses' absenteeism from the nurse managers' perspective, and it revealed absence antecedents that are rarely reported elsewhere in the literature.Implications for nursing managementThe findings from this study can be utilised to design reform initiatives concerned with nurses' absenteeism and to decrease its negative consequences in terms of quality and cost.
... One reason for this is that the phenomenon is increasing in most countries; another is that absenteeism has important effects on the functioning of such organisations. It gives rise to high costs (Davey et al. 2009) and has significant negative effects on patient satisfaction (Moret et al. 2012, Duclay et al. 2014) and, even more worryingly, on care quality (Silva et al. 2013). ...
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AimThe study aims to explore perceptions of the causes of nurse absenteeism.Background Nurse absenteeism is rising in many countries. However, there is little evidence as to how strategies adopted in order to cushion the effects of absenteeism on workload influence absenteeism itself.Method The study used a ‘qualitative’ method based on cognitive mapping techniques in order to represent perceptions about absenteeism graphically. The study was conducted in two health-care facilities with a sample of 55 interviewees.ResultsAbsenteeism is due in part to strategies adopted in order to cushion the effects of absenteeism on organisations. Furthermore, the strategies are self-legitimising. The more they are used, the more they are regarded as normal and useful.ConclusionsA plan to reduce absenteeism among nurses must explicitly take into account the strategies used to cushion its impact.Implications for nursing managementTo cushion the effects of absenteeism among caregivers, managers must make trade-offs that take into account, for example, the workload or disruption linked to the substitution of personnel.
... Ausentismo y desempeño laboral en profesionales de enfermería de áreas críticas individual: factor condicionante bajo (3-6 puntos), factor condicionante medio (7-10 puntos), factor condicionante alto (11)(12)(13)(14)(15). Dimensión lugar de trabajo: factor condicionante bajo (5-11 puntos), factor condicionante medio (12-18 puntos), factor condicionante alto (19-25 puntos). ...
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Introducción: Actualmente se considera una prioridad que los profesionales de enfermería mejoren su productividad mediante su asistencia regular y un buen desempeño profesional. Objetivo: Determinar los factores que condicionan el ausentismo y su relación con el desempeño laboral de los profesionales de enfermería que laboran en áreas críticas. Materiales y Métodos: Estudio correlacional, prospectivo, de corte transversal. La población de estudio estuvo conformada por los profesionales que laboran en áreas críticas y la muestra estuvo conformada por 65 enfermeras, mediante una muestra no probabilística. Para medir la variable ausentismo se elaboró un instrumento de 18 preguntas, dividido en cuatro dimensiones, con un índice de confiabilidad de 0,71. Asimismo, para la evaluación de desempeño, se elaboró un instrumento de 50 preguntas, dividido en 6 dimensiones, cuya aplicación se realizó mediante tres mediciones, con un índice de confiablidad de 0,93. Resultados: Resultados del ausentismo: 6.2% presentó un factor condicionante bajo en la dimensión factores individuales, 29.2% lograron un factor condicionante alto en la dimensión factores lugar de trabajo y 89.2% obtuvo un factor condicionante regular en la dimensión factores de contenido de trabajo. La evaluación de desempeño presentó que, en la autoevaluación, un 76.9% logró un nivel buen. En la evaluación de pares, el 16.9% logro un nivel deficiente, mientras que el 29.2% un nivel bueno. En la evaluación por el jefe, el 15.4% presentó un nivel deficiente, mientras que el 12.3% obtuvo un nivel bueno. Discusión y Conclusiones: El ausentismo presentó una relación directa y significativa con el desempeño laboral. Cómo citar este artículo: Díaz CR, Gutiérrez H, Amancio AM. Ausentismo y desempeño laboral en profesionales de enfermería de áreas críticas. Rev Cuid. 2018; 9(1): 1973-87. http://dx.doi.org/10.15649/cuidarte.v9i1.426
Research
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A review of litterature on the relationship between quality of working life and quality of care
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A review of the litterature on the relationship between quality of working life and quality of care
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Objective: The aim of the current study is designing a model for patient satisfaction and defining priority factors that impact patient satisfaction of healthcare services. Method: The preliminary literature search was undertaken in December 2014. A subsequent search was carried out in October 2015, which covered a majority of databases including PubMed, Scopus, ProQuest, and Magiran. Studies related to inpatients in hospitals included and related to specific area were excluded. No time bound was applied. Two of the authors independently appraised the quality of studies, and subsequently, the grouping of the variables was done using MAXqda 12 software, and the analysis was done through vote-counting method. Result: Out of 1315 articles, 85 articles were chosen for final consideration. Most of which have been carried out in developed countries. The main factors affecting consumer satisfaction in hospitals were grouped into two categories. 1-Patient attribute factors: that involved expectations, health status, demographic and socioeconomic. 2-Health system factors: that involved service quality, hospital features, staff satisfaction and insurance. Conclusion: In this study the risk of bias for each study not researched. It has been contended that the construct of consumer satisfaction is a multidimensional and subjective one. The finding of the current study suggests that all these variables be considered when evaluating patient satisfaction. The evaluation process should be performed cautiously as service providers have little direct influence over patient attribute factors.
Article
Aim To examine how personality and attitudes to sick leave influence nurses self-reported rates of absenteeism and presenteeism. Background Despite the significant economic cost and negative impact of absenteeism and presenteeism in healthcare there has been limited research looking at personality (using the 5-factor model) and absenteeism and presenteeism in nurses. Methods A cross-sectional online survey of 320 nurses. Results Low emotional stability was significantly associated with higher presenteeism. Shift work predicted more absenteeism, while those who believed that a culture of entitlement to sick leave existed in the health service were less likely to be absent from work. Increased work-related stress was also a significant predictor of presenteeism. Conclusion The results of this study highlight the role of personality, stress and attitudes in nurses' decision to be absent or present at work when they are sick. Implications for nursing management Nurses are the largest workforce in healthcare settings. Reducing absenteeism and presenteeism in nursing through a greater understanding of the influencing factors will limit the economic impacts of this behaviour and improve patient safety.
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Objective To investigate whether working 12 hr shifts is associated with increased sickness absence among registered nurses and health care assistants. Background Previous studies reported negative impacts on nurses’ 12 hr shifts; however, these studies used cross‐sectional techniques and subjective nurse‐reported data. Methods A retrospective longitudinal study using routinely collected data across 32 general inpatient wards at an acute hospital in England. We used generalized linear mixed models to explore the association between shift patterns and the subsequent occurrence of short (<7 days) or long‐term (≥7 days) sickness absence. Results We analysed 601,282 shifts and 8,090 distinct episodes of sickness absence. When more than 75% of shifts worked in the past 7 days were 12 hr in length, the odds of both a short‐term (adjusted odds ratio = 1.28; 95% confidence index: 1.18–1.39) and long‐term sickness episode (adjusted odds ratio = 1.22; 95% confidence index: 1.08–1.37) were increased compared with working none. Conclusion Working long shifts on hospital wards is associated with a higher risk of sickness absence for registered nurses and health care assistants. Implications for Nursing Management The higher sickness absence rates associated with long shifts could result in additional costs or loss of productivity for hospitals. The routine implementation of long shifts should be avoided.
Article
Aim: The aim of this study was to identify first line managers' approaches for maintaining low levels of sick leave among health care employees. Introduction: One challenge in health care is the high level of sick leave among employees. High work demands and conflicting pressures characterize the work situation of both employees and first line managers, with potential negative effects on work-related health. Method: First line managers at units with low and/or decreasing sick leave were interviewed. Thematic analysis was used to analyze the data. Results: The managers took a holistic approach in meeting their employees' broader needs and they were balancing high organizational demands through insubordination. To keep sick leave rate low, they created possibilities for the employees to influence their own working life through a present, visible and trustful leadership. Conclusion: Managers responsible for units with low sick leave seemed to utilize a holistic approach with focus on their employees, and prioritized needs of their employees before organizational demands from top-management. Implications for nursing management: First line managers in health care can have impact on sick leave among their employees and create good working conditions, despite pressure from their superiors.
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A national strategy emphasizes the accessibility of client- and patient-specific data generated in healthcare services, the development of secondary use of the data and its usability for the benefit of service provision, society and citizens in different areas of use. A lot of data is generated during the different phases of patient care; however, there is little evidence of its secondary use. Generating nursing care data and nursing intensity data are two separate processes. The purpose of this study was to evaluate the reliability of nursing intensity data after two decades of clinical use of the OPCq instrument, combine two data sets, i.e. structured clinical nursing care data (FinCC) and administrative nursing intensity data (OPCq), and compare the agreement between nursing care data and nursing intensity data. The aim was to identify areas in need of development in the FinCC and OPCq and come up with a recommendation on the possibilities of reuse of nursing care data in the assessment of patients’ nursing intensity. For this mixed-methods study multiple methods including register study, surveys and Delphi method were used. The material consisted of three data sets: 1) register data comprising the parallel classifications (n = 19 997) conducted between 2010 and 2015 to evaluate the reliability of nursing intensity classifications and survey data on the parallel classification practices used in university hospitals wards (n = 31), 2) crossmapping of the FinCC 3.0 classification and OPCq classification by a Delphi expert group (n = 16), and the associated qualitative data, and 3) combined nursing care data and nursing intensity data collected over a period of two weeks in November 2014 in university hospital wards (n = 9). The data were collected from two university hospitals and healthcare professionals familiar with the use and development of classifications. The data were analyzed using statistical methods and content analysis. According to the results, agreement between the parallel evaluations of nursing intensity classifications conducted using the OPCq instrument was good, whereas agreement between the different sections of the instrument varied. The current parallel classification method does not provide sufficient evidence of the instrument’s reliability. It was possible to cross-map the contents of the FinCC 3.0 and OPCq classifications even though there was some discrepancy in terms of content and concept use. Nurses are clearly more likely to record the implementation of nursing interventions than patients’ nursing care needs. The agreement between structured nursing documentation data and nursing intensity data was clearly seen when looking 6 at the number of FinCC classes in different nursing intensity categories: the higher the number of nursing needs and nursing interventions recorded, the higher the patient’s nursing intensity. There was discrepancy in terms of the content and number of entries between nursing care data and nursing intensity data when compared to the level of complexity of the corresponding OPCq nursing sub-area. The secondary use of nursing care data in the evaluation of nursing intensity calls for the development of the content and structure of classifications, the use of classifications enabling structured recording of data, and compatibility between nursing intensity classification and patient information systems. Keywords: Health Services, Nursing Care, Documentation, Patient Care, Nursing Records, Inpatients/classification, Nursing Assessment, Standardized Nursing Terminology
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La naissance entraîne des bouleversements pouvant impacter la santé psychique de la mère et le processus d’attachement avec l’enfant. La prise en charge faite lors de la période post-partum peut grandement influencer ces issues. Une approche centrée sur les besoins particuliers des mères, et s’appuyant sur des entretiens psychoéducatifs pour mobiliser leurs ressources, a été menée à la maternité des HUG (Genève). Cette action a montré une augmentation du sentiment de compétence des mères. Cela vient s’intégrer dans un véritable plan périnatal fondé sur l’ empowerment des femmes.
Article
Public-sector healthcare providers are on the frontline of family planning service delivery in low- and middle-income countries like Kenya, yet research suggests public-sector providers are frequently absent. The current prevalence of absenteeism in Western Kenya, as well as the impact on family planning clients, is unknown. The objective of this paper is to quantify the prevalence of public-sector healthcare provider absenteeism in this region of Kenya, to describe the potential impact on family planning uptake and to source locally-grounded solutions to provider absenteeism. We used multiple data collection methods including unannounced visits to a random sample of 60 public-sector healthcare facilities in Western Kenya, focus group discussions with current and former family planning users, key informant interviews with senior staff from healthcare facilities and both governmental and non-governmental organizations, and journey mapping activities with current family planning providers and clients. We found healthcare providers were absent in nearly 60% of unannounced visits and, among those present, 19% were not working at the time of the visit. In 20% of unannounced visits, the facility had no providers present. Provider absenteeism took many forms including providers arriving late to work, taking an extended lunch break, not returning from lunch, or being absent for the entire day. While 56% of provider absences resulted from sanctioned activities such as planned vacation, sick leave, or off-site work responsibilities, nearly half of the absences were unsanctioned, meaning providers were reportedly running personal errands, intending to arrive later, or no one at the facility could explain the absence. Key informants and focus group participants reported high provider absence is a substantial barrier to contraceptive use, but solutions for resolving this problem remain elusive. Identification and rigorous evaluation of interventions designed to redress provider absenteeism are needed.
Article
Background Systematic studies on team performance have focused on subjective measurement approaches like survey instruments, focusing primarily on identifying the most robust and psychometrically valid surveys, and not on objective measures. One of the drawbacks of identifying improvements in team performance with surveys is that we may not be considering any secular trends that may be happening between the time points that the surveys are being administered . This review aims to establish a summary of the literature that have used key performance indicators which are a set of quantifiable, measurable values to concurrently validate their team performance surveys. Methods The research question “What are the key performance indicators that are used to concurrently validate team performance in hospitals?” was addressed through a systematic review. The review was conducted and reported according to the Preferred Reporting Items for Systematic Reviewing and Meta-Analysis (PRISMA) guidelines. The search was conducted using the “ECLIPSE” framework, The databases used to perform the search were PubMed, PsycINFO (Proquest), ABIInform (Global Proquest) and CINAHL. The search was limited to studies between 2009 and 2019 (10-year period). Results The total number of articles yielded by the search was 5973, of these there were 1736 duplicates. Of the 4237 articles shortlisted for title and abstract screening, 4189 were irrelevant and 48 articles were retained for full screening. Following full text screening 33 leaving a total of 15 studies included in this review. The 15 included studies have KPIs and surveys that can be interpreted under the following common headings: Mortality, Incident Reports and Patient Safety Indicators, Absenteeism, Efficiency Metrics, and Financial Distress. The most common KPIs that the studies simultaneously assessed for impact were mortality (5) length of stay (3), patient safety indicators (3) absenteeism (2) , and financial distress (1), The most common concepts being measured by the surveys were Staff Satisfaction (5), Safety Culture (4), Patient Satisfaction (4), clinical governance (1), Support and Success (1) and Organizational Culture (1). Conclusions Patient safety managers and healthcare staff should consider exploring the use of tailored, meaningful objective metrics at the team level along with validated survey measures. Researchers could make a more meaningful contribution by conducting longitudinal studies that explore not only how these measures correlate but identifying the changes over time. However, repeated measurement and crude organizational level metrics, without more in-depth exploration and tailored interventions at the team level, cannot be expected to improve patient safety culture.
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Objetivo: Identificar como o absenteísmo na equipe de enfermagem atuante em unidade de terapia intensiva é descrito na literatura científica brasileira. Método: Revisão integrativa de literatura desenvolvida em conformidade às seis etapas metodológicas. Foram selecionados todos os artigos que respondiam à questão de pesquisa até setembro de 2020, recrutados por dois pesquisadores independentes nas bases de dados: Pubmed, LILACS, MEDLINE, BDENF e CINAHL. Após a emprego dos critérios de elegibilidade, nove artigos compuserem a síntese do conhecimento. Resultados: A busca inicial nas bases de dados resultou na seleção de 213 artigos, dos quais 209 foram excluídos por duplicidade ou por não preencherem os critérios de elegibilidade. Dos 9 artigos selecionados, 8 eram artigos originais e 1 de revisão de literatura. Os estudos eram provenientes de cinco estados brasileiros. Observou-se preocupação com a identificação das taxas de absenteísmo, as implicações do absenteísmo na qualidade do cuidado crítico prestado, às motivações para as ausências e intervenções com vistas a diminuir os índices de absenteísmo. Conclusão: As taxas de absenteísmo tendem a ser mais elevadas entre profissionais de enfermagem de nível médio. Dentre os motivos, destaca-se o relacionamento interpessoal ineficaz, sobrecarga de trabalho, falta de suporte psicossocial, duplo vínculo de trabalho e a falta de apoio para o aprimoramento profissional. Por fim, ficou evidente a necessidade de estudos de maior evidência no escopo pesquisado.
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Objective: to represent the dynamics of stress generation, accumulation and reduction in the nursing team at an oncology therapy center. Method: a mathematical simulation model of system dynamics was developed based on data collection in loco. The model served to test the impact of three policies aimed at reducing stress in the team, namely i) increase in the service load; ii) increase in the size of shift teams and iii) reduction of service hours per bed. Results: the model showed that the policy of increasing the size of the team obtained the best results, with the absenteeism index stabilizing at 8%; staff at leave also stabilizing at 4-5 people per month, as well as accumulated stress reduced to baseline levels. Conclusion: measures to monitor physical and emotional demands, hiring staff, better technical training for so-called stressful activities, and a better distribution of tasks can be effective in reducing absenteeism rates and improving the quality of life of these workers.
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Measuring the satisfaction of hospitalised patients has been mandatory in France since 1996. The most common tool for assessing the level of satisfaction is the use of self-administered questionnaires given to the patient upon his/her release from the hospital. A survey was conducted among seven public hospitals to appraise the development and use of such questionnaires, their results and the way in which these results are taken into account in order to improve the quality of care. The survey’s results illustrate that the policy with respect to their construction varies between hospitals, without any evaluation of the validity of the questionnaires produced. In most cases, the questionnaires are passively distributed to the patient at the time of discharge. The response rates are low (ranging from 4 to 18 %), and the analysis of the collected questionnaires, to the extent to which it is done, is not necessarily used to improve the quality of care. An appropriate evaluation strategy, one capable of effecting change and improving hospital care, still remains to be established in the hospitals which participated in the survey.
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Indicators describing results of care are widely explored in term of patient satisfaction (PS). Among factors explaining PS, human resources indicators have been studied in terms of burnout or job satisfaction among healthcare professionals. No research work has set out to explore the effect of absenteeism on PS scores. The objective of this study was to explore interaction between rate of absenteeism among nurses and PS results. France has taken part in a project named PATH (Performance Assessment Tool for Hospitals) of the World Health Organization, aiming to develop a tool for the assessment of hospital performance. In the first semester 2008, 25 volunteering short-stay hospitals (teaching, general and private) provide complete data on nurse short-absenteeism (periods of up to 7 consecutive days of sick leave) and on PS (a cross-sectional postal survey using a standardized validated French-language scale EQS-H exploring "quality of medical information" (MI) and "relationships with staff and daily routine" (RS)). A multi-level model was used to take into account of the hierarchical nature of the data. Two thousand and sixty-five patients responded to the satisfaction questionnaire (participation rate: 40.9%). The mean age of respondents was 58 yrs (± 19), 41% were men. The mean duration of hospitalisation was 7.5 days (± 11.1). The mean absenteeism rate for nurses was 0.24% (± 0.14).All the PS scores were significantly and negatively correlated with rate of short-absenteeism among nurses (MI score: ρ = -0.55, p < 0.01), RS score ρ = -0.47, p = 0.02). The mixed model found a significant relationship between rate of absenteeism among nurses and PS scores (MI: p = 0.027; RS: p = 0.017). Results obtained in this study show that short-term absenteeism among nurses seems to be significantly and negatively correlated with PS. Our findings are an invitation to deepen our understanding of the impact of human resources on PS and to develop more specific projects.
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To compare working conditions (ie, schedule, job demands, and practice environment) of nurses working in American Nurses Credentialing Center-designated Magnet and non-Magnet hospitals. Although nurse retention has been reported as more favorable among Magnet hospitals, controversy still exists on whether Magnet hospitals have better working conditions. A secondary data analysis was conducted of the Nurses Worklife and Health Study using responses from the 837 nurses working in 171 hospitals: 14 Magnet and 157 non-Magnet facilities in the Wave 3 follow-up survey. Contingency tables and t tests compared working conditions by Magnet status. To accommodate clustering of nurses in hospitals, the Huber-White sandwich estimator was used to obtain robust SEs and variance estimates. Nurses in Magnet hospitals were significantly less likely to report jobs that included mandatory overtime (P =.04) or on-call (P =.01), yet hours worked did not differ. They also reported significantly lower physical demands (P =.03), although the means for Magnet hospital nurses and non-Magnet nurses were quite similar (30.1 vs 31.0). Furthermore, comparison of the groups on nursing practice environment and perceived patient safety found no significant differences. Working conditions reported by nurses working in Magnet and non-Magnet hospitals varied little.
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Global nursing shortages have exacerbated time pressure and burnout among nurses. Despite the well-established correlation between burnout and patient safety, no studies have addressed how time pressure among nurses and patient safety are related and whether burnout moderates such a relation. This study investigated how time pressure and the interaction of time pressure and nursing burnout affect patient safety. DESIGN-SETTING PARTICIPANTS: This cross-sectional study surveyed 458 nurses in 90 units of two medical centres in northern Taiwan. Nursing burnout was measured by the Maslach Burnout Inventory-Human Service Scale. Patient safety was inversely measured by six items on frequency of adverse events. Time pressure was measured by five items. Regressions were used for the analysis. While the results of regression analyses suggest that time pressure did not significantly affect patient safety (beta=-.01, p>.05), time pressure and burnout had an interactive effect on patient safety (beta=-.08, p<.05). Specifically, for nurses with high burnout (n=223), time pressure was negatively related to patient safety (beta=-.10, p<.05). Time pressure adversely affected patient safety for nurses with a high level of burnout, but not for nurses with a low level of burnout.
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Patient satisfaction is receiving greater attention as a result of the rise in pay-for-performance (P4P) and the public release of data from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. This paper examines the relationship between nursing and patient satisfaction across 430 hospitals. The nurse work environment was significantly related to all HCAHPS patient satisfaction measures. Additionally, patient-to-nurse workloads were significantly associated with patients' ratings and recommendation of the hospital to others, and with their satisfaction with the receipt of discharge information. Improving nurses' work environments, including nurse staffing, may improve the patient experience and quality of care.
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The current nursing shortage, high hospital nurse job dissatisfaction, and reports of uneven quality of hospital care are not uniquely American phenomena. This paper presents reports from 43,000 nurses from more than 700 hospitals in the United States, Canada, England, Scotland, and Germany in 1998-1999. Nurses in countries with distinctly different health care systems report similar shortcomings in their work environments and the quality of hospital care. While the competence of and relation between nurses and physicians appear satisfactory, core problems in work design and workforce management threaten the provision of care. Resolving these issues, which are amenable to managerial intervention, is essential to preserving patient safety and care of consistently high quality.
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The objective of the study was to identify factors associated with satisfaction among inpatients receiving medical and surgical care for cardiovascular, respiratory, urinary and locomotor system diseases. Two weeks after discharge, 533 patients completed a Patient Judgments Hospital Quality questionnaire covering seven dimensions of satisfaction (admission, nursing and daily care, medical care, information, hospital environment and ancillary staff, overall quality of care and services, recommendations/intentions). Patient satisfaction and complaints were treated as dependent variables in multivariate ordinal polychotomous and dichotomous logistic stepwise regressions, respectively. Patient sociodemographic, health and stay characteristics as well as organization/ activity of service were used as independent variables. The two strongest predictors of satisfaction for all dimensions were older age and better self-perceived health status at admission. Men tended to be more satisfied than women. Other predictors specific for certain dimensions of satisfaction were: married, Karnofsky index more than 70, critical/serious self-reported condition at admission, emergency admission, choice of hospital by her/himself, stay in a medical service, stay in a private room, length of stay less than one week, stay in a service with a mean length of stay longer than one week. The factors associated with inpatient satisfaction elucidated in this study may be helpful in interpreting patient satisfaction scores when comparing hospitals, services or time periods, in targeting patient groups at risk of worse experiences and in focusing care quality programs.
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This paper is a report of a study to assess the impact of nurse absenteeism on the quality of patient care. Nurse absenteeism is a growing management concern. It can contribute to understaffed units, staffing instability, and other factors that could have a negative impact on patient care. The impacts of absenteeism on the quality of nursing care have rarely been studied. Retrospective monthly data from incident reports and staffing records in six inpatient units for 2004 were analysed. Dependent variables were the numbers of restraints, alternatives to restraints, incident reports, deaths, and length of stay. Explanatory variables were nurse absenteeism hours, patient days per nursing staff, and interaction between these variables. Controls were patient acuity and unit characteristics. Fixed effects regressions were analysed as regular or negative binomial models. Neither high Registered Nurse absenteeism nor high patient load was related to restraint use when taken separately. However, high Registered Nurse absenteeism was related to restraint use when patient load was high. Registered Nurse absenteeism was related to a lower use of alternatives to restraints. Incident reports were increased by high patient load, but not absenteeism, or absenteeism given patient load. When both patient load and absenteeism were high, deaths were higher also. Absenteeism alone may not be a strong factor in lowering quality, but the combination of high Registered Nurse absenteeism and high patient load could be a factor. Staffing and absenteeism may be part of a vicious cycle in which low staffing contributes to unit absenteeism, which contributes to low staffing, and so on.
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The objective was to solve two problems of an already validated scale measuring inpatient opinion on care: 1) a high non-response rate for some items due to the "not applicable" response option and 2) a skewed score distribution with high ceiling effect. The EQS-H scale ("échelle de qualité des soins en hospitalisation") comprised 26 items and 2 sub-scales of 13 items each, 'quality of medical information' (MI) and 'relationships with staff and daily routine' (RS). Three studies were conducted: a first mono-centre study (n = 552, response rate = 83.4%, self-completion of the scale the day before discharge) to construct a shorter version of the scale without the items with high non-response rate and maintaining those useful to ensure good internal validity (construct, convergent and divergent) and reliability; a second mono-centre study (n = 1246, response rate = 77.9%, self-completion of the scale before discharge) to confirm psychometric properties of the new version; a third multi-centre national study (n = 886, response rate 41.7%, self-completion at home 15 days after discharge) to test a new response pattern in order to reduce ceiling effect. Six items having a non-response rate >20% were deleted, increasing rates of exhaustive response to all items from 15% to 48%. Factorial analysis supported the evidence for removing 4 more items to ensure good internal validity and reliability of the new version. These good results (initial variance explained: 43%; Cronbach's alpha: 0.80 (MI) and 0.81 (RS)) were confirmed by the second study. The new response format produced a normalisation of the 2 scores with a large decrease in ceiling effect (25% to 4% for MI subscale and 61% to 8% for RS). Psychometric properties of the final version were excellent: the 2 subscales (8 items each) explained 66% of the variance in principal component analysis, Cronbach's alpha were respectively 0.92 (MI) and 0.93 (RS). The new version of the EQS-H has better psychometric properties than the previous one. Rates of missing values are lower, and score distribution is normalized. An English version of this scale focused on quality of medical information delivered and on relationship with staff already exists, and this could be useful to conduct cross-cultural studies of health care service quality.
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This paper is a report of a study conducted to compare levels of job satisfaction and perceptions of the quality of patient care, collaboration and teamwork among healthcare professionals in four acute care hospitals and to determine the factors associated with job satisfaction for physicians, nurses and other healthcare professionals. Positive inter-professional relationships improve quality of patient care and staff job satisfaction. Understanding how healthcare professionals perceive their relationships with each other, and identifying factors that affect their job satisfaction and perceptions of the quality patient care, inform quality improvements. This cross-sectional survey study was conducted in four hospitals in Taiwan. Data were collected in 2007 and analysed using descriptive statistics, one-way anova with the Games-Howell post hoc test and stepwise regression analysis. The survey was completed by 1475 respondent, giving a response rate of 52.2% (180 physicians, 1019 nurses and 276 other healthcare professionals). Physicians were more satisfied with their jobs (F = 26.75, P < 0.05) than either nurses or other healthcare professionals. Conversely, nurses perceived more positive collaborative relationships than did physicians or other healthcare professionals (F = 279.51, P < 0.05). Stepwise regression analysis demonstrated that perceptions of quality of patient care and collaborative relationships were the most important predictors of job satisfaction for healthcare providers. These findings provide important clues for improving interdisciplinary collaboration and ensuring quality patient care through good job satisfaction and teamwork among healthcare professionals in acute care hospitals.
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This study aimed to identify and examine predictors of short-term absences of staff nurses working in hospital settings reported in the research literature. Front-line staff nurse absenteeism contributes to discontinuity of patient care, decreased staff morale and is costly to healthcare. A systematic review of studies from 1986 to 2006, obtained through electronic searches of 10 online databases led to inclusion of 16 peer-reviewed research articles. Seventy potential predictors of absenteeism were examined and analysed using content analysis. Our findings showed that individual 'nurses' prior attendance records', 'work attitudes' (job satisfaction, organizational commitment and work/job involvement) and 'retention factors' reduced nurse absenteeism, whereas 'burnout' and 'job stress' increased absenteeism. Remaining factors examined in the literature did not significantly predict nurse absenteeism. Reasons underlying absenteeism among staff nurses are still poorly understood. Lack of robust theory about nursing absenteeism may underlie the inconsistent results found in this review. Further theory development and research is required to explore the determinants of short-term absenteeism of nurses in acute care hospitals. Work environment factors that increase nurses' job satisfaction, and reduce burnout and job stress need to be considered in managing staff nurse absenteeism.
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Before assessment can begin we must decide how quality is to be defined and that depends on whether one assesses only the performance of practitioners or also the contributions of patients and of the health care system; on how broadly health and responsibility for health are defined; on whether the maximally effective or optimally effective care is sought; and on whether individual or social preferences define the optimum. We also need detailed information about the causal linkages among the structural attributes of the settings in which care occurs, the processes of care, and the outcomes of care. Specifying the components or outcomes of care to be sampled, formulating the appropriate criteria and standards, and obtaining the necessary information are the steps that follow. Though we know much about assessing quality, much remains to be known.
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A self-report questionnaire is the most widely used method to assess (in)patients' satisfaction with (hospital) care. However, problems like nonresponse, missing values, and skewed score distributions may threaten the representativeness, validity, and reliability of results. We investigated which of alternative item-response formats maximizes desired outcomes. Five formats were compared on the basis of sample characteristics, psychometric properties at the scale and item levels, and patients' opinions of the questionnaire. Consecutively discharged patients (n=784) were sampled, of which a representative (sex, age, length of hospital stay) subsample of 514 (65%) responded. A 54-item satisfaction questionnaire addressing 12 aspects of care was used. Patients responded using either a 10-step evaluation scale ranging from "very poor" to "excellent" (E10), a 5-step evaluation scale ranging from "poor" to "excellent" (E5), or a 5-step satisfaction scale ranging from "dissatisfied" to "very satisfied" (S5). The 5-step scales were administered with response options presented as either boxed scale steps to be marked or words to be circled. E5 scales yielded lower means than S5 scales. However, at the item level, the S5 scale showed better construct validity, more variability, and less peaked score distributions. Circling words yielded fewer missing item scores than marking boxes. The E5 scale showed more desirable score distributions than the E10 scale, but construct validity and reliability were lower. No large differences among formats were found. However, if individual items are important carriers of information, a (5-step) satisfaction response scale, with response options presented in words next to each item, appears to be the optimal format.
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Nonresponse and methods of data collection could affect satisfaction measurement. The goal of this study was to estimate the impact of (1) nonresponse and (2) distribution method on evaluation of patient satisfaction in a mail-back study measuring patient opinion of medical and nursing care. The study was conducted in an adult hospital. Patients were pseudo-randomized according to the initial mode of questionnaire distribution (given at hospital or sent by mail). Three reminders were made at 1-week intervals to nonrespondents, regardless of the method of initial questionnaire distribution. Groups were distinguished according to the delay of response: initial (before any reminder), middle (after one or two mailed reminders), and late respondents (after mailed reminders plus telephone contact). The study included consecutively discharged patients to obtain 300 patients per arm. 482 patients returned the questionnaire (248 in the group receiving the questionnaire at the hospital and 234 in the other group). Groups were compared for satisfaction scores and delay of response. Early respondents were compared with middle and late respondents for patient characteristics, modality of hospital care, and satisfaction scores. Multivariate analyses were performed. Participation rate before any reminder was higher when the questionnaire was mailed than when it was given at the hospital (45% versus 39.7%, p = 0.03). The initial method of distribution did not influence patient satisfaction level. Satisfaction did not differ between respondents with or without reminders. Distributing questionnaires by mail may be preferred to distribution at discharge to optimize response rate. Reminders do not seem necessary to estimate satisfaction of overall potential respondents.
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Recently passed federal legislation requires institutions to adopt safety equipment to prevent needlesticks, but there is little empirical evidence of the effectiveness of specific types of safety devices or the contribution of safety devices to reducing needlesticks relative to the contributions of staffing, organizational climate, and clinicians' experience. In 1998, 2287 medical-surgical unit nurses in 22 US hospitals were surveyed in regard to staffing and organizational climate in their hospitals and about patient and nurse outcomes, including needlestick injuries. Hospitals provided information about available protective devices at the time of the survey. Relationships between nurse and hospital characteristics and protective equipment and the likelihood of needlestick injuries and near-miss incidents were examined. Poor organizational climate and high workloads were associated with 50% to 2-fold increases in the likelihood of needlestick injuries and near-misses to hospital nurses. Capless-valve secondary intravenous set systems and use of any type of protective equipment for IV starts or blood draws were associated with 20% to 30% lowered risks of both event types. Nurse staffing and organizational climate are key determinants of needlestick risk and must be considered with the adoption of safety equipment to effectively reduce sharps injuries.
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Measuring the satisfaction of hospitalised patients has been mandatory in France since 1996. The most common tool for assessing the level of satisfaction is the use of self-administered questionnaires given to the patient upon his/her release from the hospital. A survey was conducted among seven public hospitals to appraise the development and use of such questionnaires, their results and the way in which these results are taken into account in order to improve the quality of care. The survey's results illustrate that the policy with respect to their construction varies between hospitals, without any evaluation of the validity of the questionnaires produced. In most cases, the questionnaires are passively distributed to the patient at the time of discharge. The response rates are low (ranging from 4 to 18%), and the analysis of the collected questionnaires, to the extent to which it is done, is not necessarily used to improve the quality of care. An appropriate evaluation strategy, one capable of effecting change and improving hospital care, still remains to be established in the hospitals which participated in the survey.
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To establish the psychometric properties of the Satisfaction with Hospital Care Questionnaire (SHCQ) for measuring patient satisfaction and evaluations of hospital care quality. Patients (n = 275) and staff members (n = 83) of four hospital wards completed the 57-item SHCQ addressing 13 aspects of care. Staff members completed the SHCQ from the patient's perspective. The data were analyzed within the framework of generalizability theory. Generalizability coefficients (GCs) and standard errors of measurement (SEs). GCs indicating differentiation among patients with different overall levels of satisfaction (SHCQ mean scores) were high (> 0.90). GCs indicating differentiation among patients as to satisfaction with aspects of care (SHCQ scale scores) were generally satisfactory (> 0.75) to high. Patients agreed well on overall level of hospital care quality (GCs > 0.90) and differentiated reliably (GCs > 0.80) among aspects of care. No differentiation among wards was found with respect to quality of care. Patients and staff agreed to a considerable extent (0.78) on ranking the SHCQ items on care quality, but staff ratings were lower. Reliability and validity of patients' evaluations of quality of hospital care varied according to aspect of care. The SHCQ reliably establishes both patient satisfaction and overall quality of hospital care. Whereas patients' ratings may be too lenient, their ranking of the items on care quality appears to be valid, and is therefore suitable for monitoring and improving hospital care. Within scales, however, results should be interpreted more cautiously: for some items, patients cannot really tell the difference in quality of care.
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According to most experts, the U.S. faces a growing shortage of registered nurses, threatening the quality of care hospitals can provide. In the setting of nurse shortages and simultaneous concern about patient safety, nurses' job satisfaction and their assessment of quality of care become critical. This Issue Brief highlights a cross-national survey that describes nurses' perceptions of their hospital work environment, and identifies core problems in work design and workforce management in five countries.
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. To describe the development of the Patient Experiences Questionnaire (PEQ) and to evaluate reliability and validity of constructed summed rating scales. Literature review, focus groups and pilot surveys. Two national cross-sectional studies performed in 1996 and 1998. Two postal surveys in a national sample of 14 hospitals stratified by geographical region and hospital size. Subjects. Patients consecutively discharged from surgical wards and wards of internal medicine. The surveys included 36 845 patients and 19 578 responded (53%). We constructed 10 summed rating scales based on factor analysis and theoretical considerations: Information on future complaints, Nursing services, Communication, Information examinations, Contact with next-of-kin, Doctor services, Hospital and equipment, Information medication, Organization and General satisfaction. Eight scales had a Cronbach alpha coefficient of >0.70, the remaining two were >0.60. Repeatability was >0.70 for five scales and >0.60 for the remaining scales. The PEQ is a self-report instrument covering the most important subjects of interest to hospital patients. Results are presented as 10 scales with good validity and reliability. It emphasizes practicability and comprehensibility while at the same time providing sufficient information about domains applicable to most patients admitted to medical and surgical wards.
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The current nursing shortage and high turnover is of great concern in many countries because of its impact upon the efficiency and effectiveness of any health-care delivery system. Recruitment and retention of nurses are persistent problems associated with job satisfaction. This paper analyses the growing literature relating to job satisfaction among nurses and concludes that more research is required to understand the relative importance of the many identified factors to job satisfaction. It is argued that the absence of a robust causal model incorporating organizational, professional and personal variables is undermining the development of interventions to improve nurse retention.
Article
Donabedian's Structure-Process-Outcome paradigm is used to analyze the evolution and research on the concept of magnetism through 4 phases. The identifying foci of the original 1983 study were 4 outcomes. A large number and array of structural features were derived from the identified Magnet hospitals. The quest for excellence in nursing care continued with the Gold Standard of Magnetism case studies utilizing all identified Magnet structures, processes, and outcomes. The advent of the American Nurses Credentialing Center Magnet Recognition Program stimulated much valuable and insightful research related to outcomes associated with the large group of magnetic structures. Magnet hospital staff nurses (SNs) identification of processes/functions most essential to quality patient care highlights the Process phase. Many of the vast array of structural features attributed to Magnet hospital in 1983 are outdated and differentially defined and have not been tested for their relationship to either processes or outcomes. Identification of magnetism from an SN perspective has lagged. Recommendations include updating and clarifying structural criteria; increasing focus on the SN perspective of magnetism by continuing identification of processes; and challenging leadership in Magnet hospitals to initiate multisite evidence-based practice initiatives to link structures with process-enabling outcomes. Now may well be the time for nursing to exert leadership in expanding the Magnet concept to the total patient-care operation in a hospital.
Article
To develop a psychometrically sound, hospital patient satisfaction questionnaire to be administered to patients discharged from medical and surgical services. Cross-sectional survey in Spanish. Four acute care general hospitals of the Basque Health Service. Random samples of 650 discharged patients from each hospital during February and March 2002. A total of 1910 patients responded to the questionnaire (73.5%). Overall perceived quality of health care and perceived health improvement. No sociodemographic differences were found between respondents and non-respondents. Six dimensions were identified from the factor analysis, explaining 50% of the variance. All items, except two, revealed loadings above 0.4. Cronbach's alpha exceeded 0.7 for all dimensions, except privacy. Comfort was the dimension with the lowest level of patient satisfaction, whereas privacy was the most satisfactory. The interscale correlations never exceeded the internal consistency of each scale. The analysis of the dimensions with two items of global assessment showed a positive correlation. The results obtained from the development and validation of the questionnaire provide evidence of its psychometric properties, although it would be useful to carry out further analyses to assess time-based properties of reliability. We found a positive relation between the degree of patient satisfaction and overall evaluation of the quality of health care, providing evidence of the ability of the questionnaire to correlate with other concepts. The in-patient satisfaction questionnaire could become a useful instrument in quality-of-care assessment.
Article
To assess and to compare roles as perceived by physicians and nurses regarding medical information delivered to patients and to set this against patients' opinions on the quality of the medical information delivered to them. A questionnaire administered to 302 physicians (MDs) and 533 nurses (NUs), and an inpatient satisfaction survey administered to 1246 patients the day before discharge, as a part of a quality improvement program on patient information in a university hospital. MDs and NUs reported that diagnosis and prognosis announcements were made by MDs alone. Concerning explanations about diagnosis, information on investigations, and benefits and risks of treatment, NUs considered that they provided information in addition to MDs, while MDs considered that it was generally they alone who delivered the information. Patients were generally very satisfied with information delivered, but more than 20% were not satisfied with information on benefits and risks of investigations and treatments. The most important problem underlined by NUs was that they lacked knowledge of the medical information delivered to patients by MDs (55%). Perceived roles in the transmission of medical information to patients were very different between MDs and NUs. Patient satisfaction seemed to be greater where professional roles were clear-cut. Physicians did not recognise the primary role of the NUs. Lack of MD-NU collaboration affects the quality of patient care. A better definition of the specific roles of MDs and NUs, their training in effective methods of asserting opinions and knowledge and in conducting collaborative ward rounds would be of benefit to patients.
Relationship between inpatient satisfaction and nurse absenteeism: an exploratory study using WHO-PATH performance indicators in France High Quality Care For All: NHS Next Stage Review final report Dept
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Improvement of psychometric properties of a scale measuring inpatient satisfaction with care: a better response rate and a reduction of the ceiling effect Medical information delivered to patients: discrep-ancies concerning roles as perceived by physicians and nurses set against patient satisfaction
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Moret L., Nguyen J.M., Pillet N., Falissard B., Lombrail P. & Gasquet I. (2007) Improvement of psychometric properties of a scale measuring inpatient satisfaction with care: a better response rate and a reduction of the ceiling effect. BMC Health Services Research 7, 197. Moret L., Rochedreux A., Chevalier S., Lombrail P. & Gasquet I. (2008) Medical information delivered to patients: discrep-ancies concerning roles as perceived by physicians and nurses set against patient satisfaction. Patient Education and Coun-seling 70 (1), 94–101.
Indicateur de Mesure de la Satisfaction des Patients Hospitalis es: Questionnaire I-SATIS
French Ministry of Health (2011) Indicateur de Mesure de la Satisfaction des Patients Hospitalis es: Questionnaire I-SATIS.