Do hospitals attaining a public recognition for treating nurses fairly deliver better-quality health care? Evidence from cross-sectional analysis of California hospitals.

ABSTRACT

AIM: This study explored whether hospitals that allocate greater resources to their nursing staff provide better healthcare services than those that invest less in their nursing personnel. DESIGN: Cross-sectional logistic and tobit analyses. METHODS: We examined a sample of 314 California hospitals in 2017. We obtained a hospital's public recognition for treating nurses fairly between 2015 and 2017 from Nurse.org, the largest online community of nurses. We derived a hospital's healthcare quality in 2018 from the 2019-2020 Best Hospitals rankings released by U.S. News, a well-known media company publishing independent healthcare assessments periodically. RESULTS: Our results showed that a nurse-friendly workplace was a crucial determinant of its overall healthcare quality. CONCLUSION AND IMPLICATIONS Healthcare administrators keen to enhance the quality of healthcare services should consider creating nurse-friendly workplaces. Furthermore, their evaluation of nurses' contributions to overall healthcare quality should not solely depend on the nurse-assessed quality of care, but rather comprise not only broad aspects of patient outcomes in primary care but also patient experiences, care-related factors and expert opinions. PATIENT OR PUBLIC CONTRIBUTION Our study helped address the overwhelmed healthcare system, whose long-running shortage of nurses has been exacerbated by the COVID-19 pandemic. Our work suggested that a hospital's investment in a nurse-friendly workplace can enhance its acquisition, retention and devotion of the nursing staff. This, in turn, can have profound impacts on its overall healthcare quality. WHAT ALREADY IS KNOWN Existing empirical evidence on the relation between nurse-friendly workplace and healthcare quality is limited and inconclusive. WHAT THIS PAPER ADDS We documented evidence that the quality of healthcare services provided by hospitals varies with their treatment of nursing staff. IMPLICATIONS FOR PRACTICE/POLICY Our results provided insights into key policies that have the potential to improve healthcare quality.