The Impact of Employee Satisfaction on Patient Safety and Satisfaction Within the Hospital Setting
I
ntuitively, a hospital’s safety culture ought to be related
waits/delays, poor communication, poor care coordination, lack
nication among staff members and providing patient-
Approximately 40 percent of patients reported at least one inci-
to its service quality. Practices such as open commu-
centered care have an impact on both patient safety and patient satisfaction. This instinctively links patient safety and patient satisfaction to employee satisfaction. For example, nurses who
are satisfied and engaged and can spend sufficient time at the
bedside will presumably know their patients and their vulner-
abilities better and will be more prepared to identify and ward off potential harms.
In today’s healthcare environment, however, rarely are a hos-
pital’s safety culture and poor patient satisfaction caused by apa-
thetic staff and unwilling managers, but rather by a system that fails to support them. Leaders who create a work environment
and culture that are engaging and where people are proud to work, create engaged employees and in turn, satisfied patients.
Empirical connections between patient safety, patient satis-
of respect for personal preferences, or environmental issues. dent, and reporting incidents was associated with diminished patient satisfaction.
In its Health Care Satisfaction Report,
Press Ganey, Inc. stated “empirical evidence leads to the conclusion that increases of employee satisfaction are associated with
increases in patient satisfaction”. The Centers for Medicare & Medicaid Services (CMS) is aware of this empirical research and has developed a value-based purchasing (VBP) measure
set with performance-based financial incentives and public
reporting of quality information to comprehensively evaluate
all aspects of quality, including patient satisfaction and safety. With these changes to Medicare and Medicaid, the two largest
payment systems, employee attitudes and engagement can have a significant financial impact on a hospital’s bottom line.
With this in mind, Oakwood Annapolis Hospital’s surgical
faction and employee engagement appear in greater frequency
services department recently created a staff-driven, manage-
of service “incidents” — deficiencies in service quality such as
within the department to address the challenge of improving
ment-supported team composed of informal employee leaders
Spring 2012
in today’s literature. A recent study examined inpatients’ reports
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Customer Care News
the culture and increasing the employee engagement within
that the administration create opportunities for staff members
the group:
better understanding of the staff members’ day-to-day responsi-
the department. The team created three guiding principles for
1. Clear scope of practice: This principle is geared toward
to “job shadow” others within the department in order to gain a bilities and how their actions affect the rest of the team.
When communicating to others about a delay in the pro-
establishing responsibilities, accountability and educa-
cess, supervisors and staff from the different units within the
staff can do against the perception of what they should
daily pre-shift “huddles” and listen to their concerns or provide
tion. It is intended to help the group articulate what the be doing.
2. Culture of mutual respect and recognition: This principle
is geared toward bridging the gaps and barriers caused by
existing culture and generational differences. It focused
surgical services department were invited to attend other units’ proactive feedback regarding equipment, staffing ratios or other areas where delays could be created.
Finally, to provide increased visibility and support to the
staff, administration implemented the following items:
• A monthly “Employee of the Quarter” program to recog-
nize and reward staff members who demonstrate patient
the group on cultivating sincere, authentic relationships
safety and satisfaction behaviors in their day-to-day work;
grounded in trust and respect with a shared appreciation
employees received a nominal award
of the nursing and support service jobs. It’s also a mecha-
• A semi-annual employee appreciation event with massages
nism for rewarding and recognizing all members of the
and relaxing food and drinks during their shift
team for their impact on the patient experience.
• An employee question box and “sounding board” where employees could submit anonymous questions pertaining
3. Continuous open communication: The group established
to department needs, and management would post their
a communication plan that disseminates key messages
response on the board for all staff to see
and decisions throughout the department, implementing mechanisms to measure and act on departmental staff satisfaction and feedback.
After creating the three guiding principles, the team moved
forward in addressing the barriers within the department. This portion of work led to the development of a baseline survey
instrument to measure the existing employee satisfaction and the staff members’ perception of the existing culture. Feedback from the survey identified several gaps between nursing and
support staff, nursing and support staff to physicians, and all staff to administration. Themes among the gaps were: • Freeing up staff time so they can do their job
While the team’s progress is still ongoing, early results
are encouraging. Through the team’s use of the guiding prin-
ciples to address the gaps from the survey, the surgical services
department has seen an increase in employee satisfaction and improvement in the culture. As the team’s action plan becomes
further hardwired into the culture of the department, the intrinsic rewards of the plan (increased staff recognition, increased
staff pride in the department and a greater belief in hospital
leadership) give the staff a greater voice in the decision-making
process and ultimately lead to increased patient safety and satisfaction. CCN
• Taking personal accountability when tasks were not
Aaron Bontrager, MBA, MHA, is the director of surgical ser-
• Communicating to others when and if there will be a delay
Wayne, Mich. Bontrager can be reached at 734-467-2536 or via
completed
in the process
• Providing increased visibility and support to the staff by administration
The team then began applying the guiding principles to
address the gaps identified in the survey and then communi-
the area of freeing up staff time and taking personal accountability when tasks were not completed, the team recommended
www.customercarenews.com
e-mail at aaron.bontrager@oakwood.org. 1
Weingart S.N., Pagoviceh O., Sands D.Z., et al. (2006,
April). Patient reported service quality on a medicine unit.
International Journal of Quality in HealthCare 18(2): 95-101. 2
Wolosin, R. (2005). Health Care Satisfaction
Report. Press Ganey, Inc. 3
Spring 2012
cated the solutions back to the surgical services team. To address
vices and outpatient services for Oakwood Annapolis Hospital in
Innovators’ Guide to Navigating CMS; Version 1.0, August
25, 2008 p. 52; Centers for Medicare & Medicaid Services.
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