Maximizing The Impact of Nursing Care Quality

By Ann Hendrich, MSN, RN, FAAN; and Marilyn Chow, RN DNS, FAAN

Published by The Center for Health Design and Georgia Institute of Technology, 2008

EXECUTIVE SUMMARY

Nurses are the cornerstone of hospital care delivery and the hospital’s most costly and valuable resource; their efficiency and effectiveness are central to any effort to maximize patient safety or minimize costs. Studies suggest that elements of the current hospital work environment, including inefficient work processes and physical designs, gaps in technology in- frastructure, and unsupportive organizational cultures, contribute to inefficiencies and stress for hospital nurses, limiting the time they can spend in direct patient care. These same elements contribute to nurse burnout, which, in turn, hinders the recruitment and retention of nurses. Furthermore, reduced nurse-patient ratios have been linked to increased mortality, highlighting the fact that nurse staffing and efficiency are linchpins of patient safety. Innovations in hospital design and work processes have the potential to enhance the recruitment and retention of staff, increase the efficiency of care delivery, and improve the quality of clinical care and pa- tient safety while avoiding reimbursement penalties.

This article reviews the evidence relating to nursing work processes and their inseparability from physical space, infrastructure, and patient safety and highlights potential solutions to promote transformational change to the nursing work environment.