Nurses’ Week Series: A ‘culture of safety’ for nurses improves patient outcomes and the bottom line

Marcia Faller, PhD, RN, Chief Clinical Officer, AMN Healthcare -

This article is part of our Nurses' Week Byline Series which will speak to the important theme of Nurse Safety.

A safe work environment not only protects nurses, it also ensures better patient outcomes and actually improves the bottom line for healthcare organizations.

So, the theme for this year's National Nurses Week -- "Culture of Safety" – can benefit everybody.

The American Nurses Association defines a culture of safety as having core values and behaviors resulting from a collective and sustained commitment to emphasize safety over competing goals. Such cultures value openness and trust, appropriate resources for safe staffing, the ability to learn from our mistakes and assess our weaknesses, and accountability.

Many factors contribute to a culture of safety, but I'd like to focus on three in particular that affect patient satisfaction and ultimately the bottom line, because hospitals are now financially incentivized to achieve high ratings from patients:

1. Better work environments
A recent study by the University of Pennsylvania School of Nursing Center for Health Outcomes and Policy Research (CHOPR) examined the relationship between nursing and patient satisfaction across 430 hospitals. Using data from three sources—the national Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, a four-state nurse survey of hospital quality, and the American Hospital Association Annual Survey -- the study concluded that patients reported higher satisfaction in hospitals where nurses practice in better work environments, in which nursing leadership, nursing standards for high-quality patient care, and nurse-physician relationships are a priority.

2. Nursing excellence
Another study by CHOPR and the New York University College of Nursing focused on the impact of magnet hospitals on patient satisfaction. The Magnet Recognition Program distinguishes healthcare providers for quality patient care, nursing excellence and innovation in nursing practice. It's the gold standard for the nursing environment. The study showed that magnet hospitals scored higher in patient ratings than other hospitals. The reason? Patient experience is directly related to the level of nurse staffing and the status of nursing environment. And that may be linked to hospital reimbursement rates, the study concluded.

3. Adequate staffing
The obvious benefits of improved nurse safety include reduced costs from workers' compensation expenses, lawsuits, and nonproductive time. In fact, The Bureau of Labor Statistics reported that in 2014 the healthcare industry had the most days-away-from-work incidents compared to all other industries. The single greatest risk factor for overexertion injuries in healthcare is the manual lifting, moving and repositioning of patients. We can reduce that risk by providing adequate staffing, according to a study published by the American Journal of Public Health. Adequate staffing not only correlates with fewer injuries, but it also has another benefit. The CHOPR study I cited earlier regarding better working environments reported that more favorable patient-to-nurse ratios improved patient satisfaction.

Clearly, a culture of safety is important to a good care environment, for both nurses and patients. And now reimbursements are being more directly linked to patient experience, healthcare organizations that espouse a culture of safety are more likely to reap rewards in patient care, staff retention and safety – and the bottom line.

Learn more:
Patient Satisfaction Scores Boosted by Better Nurse Staffing
For Nurses, Compassionate Scheduling through Predictive Analytics
Study Finds Kaiser Permanente's Investment in Nurses is Vital to Patient-Care Quality

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