Please use this identifier to cite or link to this item: http://dx.doi.org/10.14279/depositonce-6328
Main Title: Patient safety, satisfaction, and quality of hospital care: cross sectional surveys of nurses and patients in 12 countries in Europe and the United States
Author(s): Aiken, Linda H.
Sermeus, Walter
Van den Heede, Koen
Sloane, Douglas M.
Busse, Reinhard
McKee, Martin
Bruyneel, Luk
Rafferty, Anne Marie
Griffiths, Peter
Moreno-Casbas, Maria Teresa
Tishelman, Carol
Scott, Anne
Brzostek, Tomasz
Kinnunen, Juha
Schwendimann, Rene
Heinen, Maud
Zikos, Dimitris
Sjetne, Ingeborg S.
Smith, Herbert L.
Kutney-Lee, Aann
Type: Article
Language Code: en
Abstract: OBJECTIVE: To determine whether hospitals with a good organisation of care (such as improved nurse staffing and work environments) can affect patient care and nurse workforce stability in European countries. DESIGN Cross sectional surveys of patients and nurses. SETTING: Nurses were surveyed in general acute care hospitals (488 in 12 European countries; 617 in the United States); patients were surveyed in 210 European hospitals and 430 US hospitals. PARTICIPANTS: 33 659 nurses and 11 318 patients in Europe; 27 509 nurses and more than 120 000 patients in the US. MAIN OUTCOME MEASURES: Nurse outcomes (hospital staffing, work environments, burnout, dissatisfaction, intention to leave job in the next year, patient safety, quality of care), patient outcomes (satisfaction overall and with nursing care, willingness to recommend hospitals). RESULTS: The percentage of nurses reporting poor or fair quality of patient care varied substantially by country (from 11% (Ireland) to 47% (Greece)), as did rates for nurses who gave their hospital a poor or failing safety grade (4% (Switzerland) to 18% (Poland)). We found high rates of nurse burnout (10% (Netherlands) to 78% (Greece)), job dissatisfaction (11% (Netherlands) to 56% (Greece)), and intention to leave (14% (US) to 49% (Finland, Greece)). Patients’ high ratings of their hospitals also varied considerably (35% (Spain) to 61% (Finland, Ireland)), as did rates of patients willing to recommend their hospital (53% (Greece) to 78% (Switzerland)). Improved work environments and reduced ratios of patients to nurses were associated with increased care quality and patient satisfaction. In European hospitals, after adjusting for hospital and nurse characteristics, nurses with better work environments were half as likely to report poor or fair care quality (adjusted odds ratio 0.56, 95% confidence interval 0.51 to 0.61) and give their hospitals poor or failing grades on patient safety (0.50, 0.44 to 0.56). Each additional patient per nurse increased the odds of nurses reporting poor or fair quality care (1.11, 1.07 to 1.15) and poor or failing safety grades (1.10, 1.05 to 1.16). Patients in hospitals with better work environments were more likely to rate their hospital highly (1.16, 1.03 to 1.32) and recommend their hospitals (1.20, 1.05 to 1.37), whereas those with higher ratios of patients to nurses were less likely to rate them highly (0.94, 0.91 to 0.97) or recommend them (0.95, 0.91 to 0.98). Results were similar in the US. Nurses and patients agreed on which hospitals provided good care and could be recommended. Conclusions Deficits in hospital care quality were common in all countries. Improvement of hospital work environments might be a relatively low cost strategy to improve safety and quality in hospital care and to increase patient satisfaction.
URI: https://depositonce.tu-berlin.de//handle/11303/7007
http://dx.doi.org/10.14279/depositonce-6328
Issue Date: 2012
Date Available: 26-Oct-2017
DDC Class: 610 Medizin, Gesundheit
Subject(s): general medicin
patients
medical error
patient safety
quality improvement
Creative Commons License: https://creativecommons.org/licenses/by-nc/2.0/
Journal Title: BMJ
Publisher: BMJ Publishing Group
Publisher Place: London
Volume: 344
Article Number: 344:e1717
Publisher DOI: 10.1136/bmj.e1717
EISSN: 1468-5833
ISSN: 0959-8138
Appears in Collections:Fachgebiet Management im Gesundheitswesen » Publications

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