Engaging the Workforce to Drive Safety, Quality and Experience Excellence

Added on Apr 20, 2017

Engaging the Workforce to Drive Safety, Quality and Experience Excellence
By Diana Mahoney
Industry Edge April 2017

The rapidly evolving health care industry has created a new standard of excellence in care delivery defined by optimal performance across measures of safety, quality, value and patient experience—and the key to achieving it lies in the health care workforce.

New research published in Press Ganey’s 2017 Strategic Insights report, “Achieving Excellence: The Convergence of Safety, Quality, Experience and Caregiver Engagement,” confirms this idea. The report highlights the findings of multiple cross-domain analyses that demonstrate interdependent relationships between and among safety, quality, patient experience and caregiver engagement, as well as the influence of those relationships on financial performance.

High performance in any one of these domains can positively influence the others and support forward progress on the improvement journey, while a defect or deficiency in any one of the areas can compromise the others, according to the findings. For example, an analysis of the relationship between HCAHPS patient experience domains and clinical safety and quality outcomes from Hospital Compare shows that health systems in the top quartile for multiple HCAHPS patient experience domains have lower rates of hospital-acquired conditions, shorter lengths of stay and fewer readmissions than systems that perform in the bottom patient experience quartile.

Similarly, systems in the top quartile for physician and employee engagement have lower rates for most hospital-acquired infections than those in the bottom quartile, as well as shorter lengths of stay, fewer readmissions, better hospital-acquired condition (HAC) scores and lower Patient Safety and Adverse Events Composite (PSI 90) scores. And organizations with top-quartile performance on an NDNQI® nursing composite measure derived from subscales of the Practice Environment Scale–Nursing Work Index (PES–NWI) perform better across safety, quality and patient experience measures than those with low median composite scores.

The analyses also demonstrate positive associations between organizations’ financial performance and both workforce engagement and patient experience scores. Specifically, health systems in the top performance quartile for physician engagement, employee engagement and nursing composite scores and those with higher overall patient experience performance on the HCAHPS Likelihood to Recommend and Overall rating domains have higher net margins and lower per-patient spending for readmissions than those in the respective bottom quartiles.

The findings suggest that moving the needle on any one of these care attributes—safety, quality, experience or caregiver engagement—influences performance directly or indirectly in all of them. Because the human capital of an organization is the common denominator across all of these domains, the development of a robust, engaged workforce should be a strategic priority for health systems seeking to make sustained, meaningful progress on the road to excellence.

Download Press Ganey’s 2017 Strategic Insights report.