The results come as no surprise to anyone who has ever worked in the nursing field, but now a new study proves it beyond a reasonable doubt - quality care and success depend on the happiness of the hospital's nursing staff.
A study out of University of Pennsylvania focused on the role of Kaiser Permanente's nursing organization in promoting quality of care. The Kaiser Permanente model of integrated health delivery is highly regarded for high-quality and efficient health care. Efforts to reproduce Kaiser's success have mostly failed. One factor that has received little attention and that could explain Kaiser's advantage is its commitment to and investment in nursing as a key component of organizational culture and patient-centered care.
Patient and nurse outcomes in Kaiser hospitals were significantly better compared with non-Magnet hospitals. Kaiser hospitals had significantly better nurse work environments, staffing levels, and more nurses with bachelor's degrees. Differences in nursing explained a significant proportion of the Kaiser outcomes advantage. Kaiser hospital outcomes were comparable with Magnet hospitals, where better outcomes have been largely explained by differences in nursing.
“We are proud to be recognized as a leader in providing quality nursing care,” said Marilyn Chow, vice president, Kaiser Permanente, National Patient Care Services and Innovation. “This study validates what we know and witness every day at our medical centers: our patients benefit because Kaiser Permanente nurses are among the best in the country.”
The study was a cross-sectional analysis of linked secondary data from multiple sources, including a detailed survey of nurses, for 564 adult, general acute care hospitals from California, Florida, Pennsylvania, and New Jersey in 2006-2007. Using logistic regression models to examine whether patient (mortality and failure-to-rescue) and nurse (burnout, job satisfaction, and intent-to-leave) outcomes in Kaiser hospitals were better than in non-Kaiser hospitals, researchers assessed whether differences in nursing explained outcomes differences between Kaiser and other hospitals. Finally, the study examined whether Kaiser hospitals compared favorably with hospitals known for having excellent nurse work environments-Magnet hospitals.
An important element in Kaiser's success is its investment in professional nursing, which may not be evident to systems seeking to achieve Kaiser's advantage. The results suggest that a possible strategy for achieving outcomes like Kaiser may be for hospitals to consider Magnet designation, a proven and cost-effective strategy to improve process of care through investments in nursing.
“This has enormous implications in hospital settings, given nurses’ key role in the process of clinical surveillance,” said Matthew McHugh, PhD, JD, MPH, RN, professor at University of Pennsylvania Nursing and primary author of the study “Achieving Kaiser Permanente Quality.”
What do you think? Do you agree with the study's results and how does "happiness" impact your day-to-day nurse life? Share your thoughts in the comments section below.