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How do Nurses Impact HCAHPS Scores?

May 10, 2018


PRC is celebrating Nursing Week 2018! We love and are proud of all our nursing partners across the country. Keep up the amazing work, nurses, none of us can do it without you!

If sickness is a battle and physicians are the commanding officers, nurses are the frontline infantry, deep in the trenches and carrying the weight of the war on not enough shoulders. What does that mean for patients? According to HCAHPS scores, quite a lot. Nearly a decade ago, Kutney-Lee et al. published their research on the relationship between happy nurses and happy patients. This paper posited that a significant relationship exists between the nurse work environment and all HCAHPS patient satisfaction measures, not just those related to nursing. Eight years and multiple studies later, this continues to hold true.

Treating nursing staff with courtesy and respect is one of the strongest ways a hospital can improve their scores and—perhaps more importantly—boost and strengthen morale. Minding nurse satisfaction, work environment, and burnout rates significantly impacts HCAHPS scores across all dimensions.

The HCAHPS survey encompasses nine key topics which contain 21 patient perspectives on care, totaling 27 questions. Of those nine key survey topics, nursing care directly impacts seven. These include information about the patient’s likelihood to recommend the hospital and their satisfaction with the discharge process. Perhaps unsurprisingly, Kutney-Lee et al. found a relationship within these dimensions as well. These patient satisfaction scores often indicate how well the hospital staff, notably the nurses, practice patient-centered care.

Though sometimes seen as being controversial, patient-centered care has been at the core of nursing since its inception. The famous founding nurse Florence Nightingale first described patient centered care in her nursing model, which placed the patient at the forefront of all nursing concerns. She proposed that a relationship equally exists between the patient’s health, their surroundings, and the skills of the nurse providing care. With this, nightingale believed that patients are likely to recover quicker if placed in a healthy environment with access to high-quality nursing care. To this day, more than 150 years later, Nightingale’s theories have been regularly supported by new empirical evidence as well as trends in HCAHPS scores.

Hospitals face undeniable difficulty creating and sustaining a healthy and thriving nurse culture. Obstacles such as nursing shortages and cost containment efforts place a strain on nurses as well as on their team and patients. Nonetheless, it is critical to the success of any hospital that leadership strives for a culture of nursing excellence, arming their frontline soldiers with the support and resources to win the battle against every ailment in their hospital—no matter the cost.


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