Senior healthcare leaders surveyed about their top nursing challenges shine a spotlight on the unique dichotomy of nursing staff responsibilities.
According to the March 2017 HealthLeaders Media Nursing Excellence Survey, healthcare leaders say that nursing staff performance is measured using tools that are both clinical and nonclinical in nature, demonstrating the unique dichotomy of nursing staff responsibility.
Survey respondents indicate that the primary method of tracking and measuring nursing staff performance at their organizations is HCAHPS or other CMS surveys (76%). This is followed by post discharge phone calls (50%), in-house survey activity (non-CMS) (46%), and Press Ganey (45%).
Note that the top two responses are used mainly to track nurse performance in terms of patient experience and satisfaction, compared with the more clinically oriented measurement offered by the National Database of Nursing Quality Indicators (NDNQI) (42%), which falls in the middle of the response range.
"In our organization, we measure compliance with the bedside shift report, purposeful rounding, as well as the things we measure through the nursing domain of HCAHPS," says Jennifer Gentry, MSN, RN, NEA-BC, chief nursing officer at CHRISTUS Spohn Hospital Corpus Christi - Memorial and CHRISTUS Spohn Hospital Corpus Christi - Shoreline, part of the Texas-based CHRISTUS Spohn Health System with six hospitals and more than 15 medical clinics throughout southeast Texas.
But she acknowledges that HCAHPS is flawed in terms of nursing's clinical mission, and that it is viewed mostly as a patient satisfaction survey by her staff. For this reason, CHRISTUS Spohn Health System also relies on the NDNQI tool.
Survey responses reveal that organizational size is correlated with how organizations track and measure the performance of their nursing staff.
For example, based on net patient revenue, a greater share of large (85%) organizations than medium (76%) and small (69%) organizations mention HCAHPS or other CMS surveys as ways to track and measure the performance, and a greater share of large organizations (59%) than medium (49%) and small organizations (49%) cite postdischarge phone calls. Further, a greater share of medium (56%) and large (56%) organizations than small (37%) organizations mention Press Ganey, and a greater share of medium (53%) and large organizations (51%) than small organizations (31%) cite the NDNQI.
Note that the one exception to the organizational size correlation is for in-house survey activity (non-CMS) where, based on net patient revenue, a greater share of small organizations (55%) than medium (43%) and large (28%) organizations mention it as a way to track and measure nursing staff performance.
This is likely because small organizations, due to their smaller footprint and lower nursing staff levels, may more easily track nurses using in-house staff than larger organizations that have more locations and higher nursing staff levels.
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Source: HealthLeaders Media Intelligence Report, Nursing Excellence: Leadership Development, Culture, and Retention; March 2017.
Jonathan Bees is a research analyst for HealthLeaders.