Gallup research has documented time and again that -- no matter the industry -- person-to-person relationships have a huge impact on client satisfaction. Healthcare managers and researchers have long assumed a direct causal link between employee performance and patient satisfaction. Studying patient data from more than 200 hospitals in 38 states, Gallup found a significant relationship between overall patient satisfaction and patient assessment of the employee performance.
In the healthcare industry, Gallup surveys indicate that the more direct patient contact a specific job role entails, the greater the role's impact on patient satisfaction. For this reason, nursing roles dramatically affect levels of patient satisfaction. This relationship creates a dilemma for healthcare managers. Great nurses elicit high levels of patient satisfaction. But during staffing shortages, can you maintain patient satisfaction levels with a smaller staff of great nurses or does the actual number of nurses affect patient satisfaction?
Nurse Staffing Impacts Overtime and Turnover
To examine the impact of nurse staffing on satisfaction, Gallup conducted proprietary research for a number of hospitals. Not surprisingly, this research indicates that there is a strong relationship between the number of nurses per patient, per day and key nursing performance indicators such as the percentage of overtime hours and nursing turnover rates. The greater the number of nurses on staff for each patient day, the lower the percentage of overtime hours and the lower the nursing turnover rate.
Gallup research also found that decreasing the nurse-to-patient-day ratio (namely, decreasing the number of nurses per patient) does not improve a hospital's financial performance -- that is, there appears to be no significant relationship between nurse-to-patient-day ratio and earnings.
Nurse Staffing and Patient Satisfaction
Nurse staffing, number of overtime hours, and turnover also significantly affect the perceived quality of patient service. Gallup found a strong relationship between the number of nurses per patient day and inpatient satisfaction -- the more nurses per patient day, the higher the level of satisfaction. Also, the higher the percentage of overtime hours and turnover, the lower the level of patient satisfaction.
Many healthcare managers are caught in a vicious cycle. In times of shortage, nursing vacancies increase. Financial pressures may result in fewer nurses per patient. Reductions in the number of nurses per patient day increase overtime hours and turnover. All these factors contribute to a decline in patient satisfaction.
How can this cycle be broken? Attracting more nursing students is one long-term strategy to increase supply. In the short term, the key is to increase efficiency and reduce turnover.
Nurse quality and quantity both affect patient satisfaction. To break the cycle of nursing shortage, nursing turnover, and low patient satisfaction, healthcare organizations must concentrate on short-term, controllable factors such as smart hiring and promotion. Increasing retention and productivity helps hospitals to become preferred places of employment among nurses, and can break the shortage cycle. The choice is not "great nurses" or "more nurses", both are necessary for success.