How Great Nursing Improves Doctors’ Performance

From the Harvard Business Review:

In our research, we looked at the association  between superior nursing (as indicated by Magnet status) and hospital scores on the national HCAHPS patient satisfaction survey as well as within Press Ganey’s database of over 2,000 health care organizations. HCAHPS gathers patients’ feedback on many aspects of their hospital experience from the hospital environment, quality of the food, and staff responsiveness to how well doctors and nurses communicate with them (Do they listen? Are they respectful? Do they explain things well?).  The survey also asks for an overall rating of the hospital. Ratings are often expressed in terms of the “top box” score — the percentage of patients who give the hospital a superior score on a given measure. We found that Magnet hospitals outperformed the non-magnet hospitals on patients’ “likelihood to recommend” top box scores (75.7 compared to 70.8) and we saw a similar spread on the “overall rating score” (76.0 vs. 72.8). We also saw a smaller but significant difference on patient assessment of physician concern about the patient’s questions or worries, which gauges courtesy and respect, listening, and explaining.

Press Ganey’s proprietary survey also revealed a meaningful association between Magnet status and higher patient ratings of physicians’ skill, response to concerns, time spent with the patient, friendliness and courtesy and other measures.  Mean scores for Magnet facilities ranged from 84.6 for “time physician spent with you” to 93.2 for “skill of the physician” while mean scores for non-Magnet facilities ranged from 83.6 to 92.1 for the same questions. These may appear to be subtle differences but they are meaningful. Even a few points change in mean score has a dramatic effect on the percentile rank due the tight compression of scores nationally; for example, an increase of just two points on a mean score (from, say about 88 to 90) can mean the difference between being in the 50th percentile versus the 75th.

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