Supporting front-line hospital staff leads to safer and happier patients

Hospitals that use supportive management practices across diverse care providers and front-line staff are more likely to deliver quality patient care, according to a new study in Health Services Research.

The study’s lead author, Dana Beth Weinberg, Ph.D., associate professor at Queens College and the department of sociology at the Graduate Center-CUNY said, “The key finding was the strong relationship between the way hospitals value and support their workforce and a range of outcomes that are important to patients, hospitals and care providers.”

Supportive management practices include involving workers in decision-making; facilitating communication and information sharing; and human resource practices that focus on developing workers’ skills and recruiting and retaining qualified workers.

To examine the effects of these practices, researchers sent surveys to a wide variety of workers at nine New York hospitals, including small rural hospitals and large health centers, as well as seven health systems. They received responses from1527 doctors, nurses, nurse’s aides, rehabilitation therapists and other front-line staff.

Survey results showed that management practices are related to organizational performance, job satisfaction and employee retention. Hospitals with a more supportive work environment had higher rates of patient satisfaction and lower odds of adverse patient events.

Weinberg noted, “How we treat hospital workers—whether we support them, give them a say in decisions about their work, and treat them not as interchangeable or dispensable cogs in a wheel but as a valued resource—affects their ability to work together to provide care that patients want and need.”

The link between better jobs and delivering good care in work environments is not new, but this study is one of the first that examines the contribution of a high performance work environment across a broad range of health care occupations and outcomes. Previous research has primarily studied performance and work environments of nurses.

Steve King, organizational development manager with St. Mary’s Hospital in Madison, Wisconsin, said he wasn’t surprised by the findings. “We have had numerous studies tying employee engagement to a number of outcomes over the past decade in particular. For 20 years, we have used a ‘shared governance’ structure based on the notion that better care delivery and outcomes are achieved by giving caregivers a greater hand in making decisions that affect their work.”