Nursing Research Utilization Essay

Nursing Research Utilization Essay

Nowadays it has become apparent that health care is a commodity purchased competitively. In any competitive market, the goal is to make profit. In order to increase the proportion of his\her customers, a health provider must create customer loyalty. To do this, taking into consideration that health care provision is a delicate industry, much more than technical and professional support is needed: they need a human factor. In 2005, a survey indicated that 65 percent of respondents deemed compassionate staff to be more valuable than technology. Patient satisfaction is not the only one sided ideal; it goes to serve both a patient and a healthcare service provider; patient satisfaction also goes into earning revenue for a hospital, in addition, to creating a congenial work environment. In the case of a community hospital, increased goodwill to the hospital from the local community shows increased patience satisfaction; conversely, disgruntled patients are difficult to work with, and they might air out their opinions to the public leading to the fact that a hospital might have a wounded self-image which is difficult to repair.Nursing Research Utilization Essay

Patient satisfaction is not easy to achieve, especially in such hospital departments like the emergency department; however, there are measures that can be implemented in order to reduce dissatisfaction such as keeping the patient informed on the causes of the delay or the progress that a loved person doing. To achieve patient satisfaction faster and easier the duty does not solely lie on the employees and the physicians; the responsibility lies also on the society. Patients and relatives should be forth-coming with information and use the proper channels to address the grievance.

Communication is a paramount in achieving patient satisfaction. The patient should be consulted in decision making; this makes him/her feel appreciated and respected. In the health care system emotions flare up; thus, it is necessary to know how to diffuse these situations without causing further aggression.Nursing Research Utilization Essay Once a hospital embarks on a patient satisfaction strategy, there is no turning back. Adequate measures must be put in place in order to sustain the patient’s satisfaction at the current level. Regular monitoring and evaluation of the patients` satisfaction strategy success or shortcomings should be carried out from time to time. It is a dynamic process; clear-cut techniques do not exist; instead, hospitals should tailor their policies to suit those that will satisfy the consumer and to terminate those which no longer benefit the society. At the micro-level, managers use patient satisfaction to set goals while at the national level, it is a tool for public accountability.

The objective of this paper is to establish a framework that a community hospital can use to increase patient satisfaction scores by 10 percentile for discharge instruction in Press Ganey Survey. This framework can be adopted by other hospitals of its size; however, this study does not exclude that large hospitals can use this framework, modifying it to suit their needs. Data, collected using various forms of data collection, is analyzed using such statistics tools as regression analysis and correlation. The paper contains a clear implementation plan of the proposed solution into a work setting.  In conclusion, the researcher gives suggestions that can be used to maintain, extend and terminate a proposed solution to the customer dissatisfaction problem.Nursing Research Utilization Essay



Patient satisfaction is not easy to achieve due to the complicated nature of health care needs. Patients are like other consumers; when they purchase a commodity or service, they expect to derive the greatest utility from the commodity or service purchased. There are several factors that make providing health care more complicated than any other service. The long hours of interaction between patients and nurses and/or doctors can put a strain on that relationship. When in hospital patients are more likely to experience tumultuous emotions that make them irritable; it burdens the care giver and influences the quality of care that patients receive; these emotions characterize intense feelings that are sometimes difficult to express. In recent years, there is a widening gap between technical expertise and patient tolerance. A fully equipped hospital by both technological facilities and staff may be lacking a patient understanding. An increasing number of people seeking medical care need an understanding team of medical practitioners.

Patient satisfaction is a paramount at both – macro- and micro –levels. At the macro-level, it can be used for public accountability and increasing competition, while social benefits are accrued by the patients at the micro-level. Patient satisfaction takes various dimensions depending on the demographic category that a patient belongs to. Many female patients seek empathy, professional co-ordination between the various departments and emotional care. The elderly, on the other hand, will consider a facility as satisfactory when it is physically easy to access, provides regular communication and staff identification. To achieve patient satisfaction when dealing with patients from different cultural backgrounds, hospital staff has to be aware and well-informed about the cultural diversity of their patients (Lee, 2004).

Organizational Overview

Community hospitals bring the intensely needed primary health care facilities to people in the remote areas. In addition, they reduce the pressure in other main hospitals. They provide services such as diagnostics, surgery, emergency care and intermediate care. Primary health care is the main form of health care offered by community hospitals. Primary health care system is a health care system where the general practitioner is responsible for running the hospital which includes patient selection, admission and management. The general practitioners work in liaison with nurses, consultants, midwives and other medical personnel when it is necessary. A community hospital’s loyalty lies on the patient. The main aim of community hospital is to provide health care to local community.Nursing Research Utilization Essay

Statement of the problem

The problem is to increase patient satisfaction scores by 10 percentile for discharge instruction in Press Ganey Survey in a small community hospital.  Increasing patient satisfaction for hospitals has become almost mandatory; after the recent announcement by Medicare/Medicaid declaring that they would categorize hospitals according to patient satisfaction and use those results as a criterion of payment for performance. Press Ganey is a company which is solely concerned in assisting hospitals to achieve patient satisfaction, and it offers several components that can be used to identify the key components that should be used to measure patient satisfaction (Gupta, 2004).


To demonstrate the need to achieve patient satisfaction

To develop a concise plan that administrators can use to ensure that their hospitals are patient centered.

To determine if patient satisfaction in a hospital correlates to an increase in its revenue Nursing Research Utilization Essay

To determine what are the most influential factors in patient satisfaction.

Significance of the Research

Patient satisfaction is crucial because it is the most infallible measure of an organization’s performance. In addition, it enhances community participation by exercising their democratic right. The purpose of this study is to establish the ways in which patient satisfaction can be increased (Press, 2005).

Organization of the Study

This study is organized in three main sections which are divided into sub sections. Chapter one is the introduction to the patient satisfaction topic and an organizational overview of community hospitals. In this chapter, the researcher also identifies the problem that this research paper wishes to resolve. A wise description on how the proposed solution will be implemented follows. It also contains literary support on the consistency of the solution to the current research knowledge. The feasibility of the proposed solution in a work setting is discussed in this chapter.Nursing Research Utilization Essay

In order to increase patient satisfaction, health providers need to shift in order to have a more patient centered system. This will be done by use of follow up phone calls to the patients. The process of discharge starts at admission and ends at the day the patient is discharged from the hospital.  The follow up phone calls will be used to investigate on the patients experience in the hospital. Post discharge phone calls will enable the employees of the hospital to focus on the post-hospital phase of recovery. It will enable the physicians and nurses to follow up on the patients progress through family members. Physicians will keep track of the patients to ensure that verbal and written symptoms that are likely to come up during that period. This applies to both large and small community hospitals. Patient satisfaction can be achieved through quality assessment and quality improvements (Barton, 2003). The quality assessment is used to analyze the personal relationships between the patient and the physician. Quality improvement involves changes to the hospital operations in order to meet the expectations of a customer or patient that are outlined in the quality assessment process.

Quality assessment and improvement strategies of improving patient centeredness are wholesome strategies: they involve all the stakeholders’ concerned (employees, patients and physicians). In seeking the opinion of each person concerned, it will give a sense of team spirit to the strategy which will enhance cooperation and subsequently the strategy success.Nursing Research Utilization Essay

The main aim of a community hospital is to offer primary health care services (Shi & Singh, 2005) at an affordable cost. Incorporating all the individuals into the project will not only help in achieving patient satisfaction but also attain its objective of involving the local community in its operations.

Literature Review

The solution of patient dissatisfaction can be achieved through a series of strategies. However, the most important of these strategies are quality assessment and quality improvement. In order for any health center to achieve patient satisfaction, an integral role must be played by the health care providers. When a patient searches a health care provider, just like in the case with any other service or product, he/she develops tastes and preferences and thus identifies attributes that he/she likes and chooses the health provider according to personal criteria. The hospital administration and staff should maintain the attributes of the hospital that attract the customer/patient to them whilst improving on what is necessary. For any hospital to be successful in achieving the objectives stated above, an evaluation to assess the current situation should be carried out. This information will enable the hospital to establish what is relevant to the patients, employees and physicians. Qualitative data can be collected through the appropriate methods of data collection such as interviews, questionnaires and observations. Qualitative data can be collected through surveys, Press Ganey data and process maps. The appropriate tools of statistics are used to determine the most significant variable; quantitative data will be analyzed using the regression model while quantitative data will be analyzed using correlation method.Nursing Research Utilization Essay


Administrators use patient satisfaction surveys to take a glance into the inner operations of their hospitals. They are also used as a tool for setting administrative and management goals (Wadhwa, 2004). The evolution towards patient centeredness has increased in pace due to the shift from objective to subjective medicine, pressure to increase accountability and a wide variation in clinical practice.  However, patient satisfaction is not only beneficial to the patient but also to the community hospital; if the top level employees are satisfied with the quality of services in a hospital, then they will provide high quality care. High quality care will increase business in a hospital and increase the revenue of the hospital to break-even point. This is a formidable challenge, more so for community hospitals that must provide health care services at an affordable price while remaining solvent (Press, 2005). The use of the word customer instead of patient in the healthcare system is one of the most telling characteristics of a change from objective to subjective medicine. This places the concept that the health industry is a competitive market (Barton, 2003). This shift, therefore, should be accompanied by changing the way services are rendered; like in any competitive market, those organizations that take into consideration patient satisfaction are the ones that plough the benefits, mostly in terms of profits (Wadhwa, 2002). Quality can be used as a measure of a patient satisfaction by evaluating the personal comfort received during and after his/her stay in the hospital (Shi & Singh, 2005). According to Shi and Singh (2003) factors that show compassion will keep the existing customers of the hospital, creating customer loyalty.Nursing Research Utilization Essay

Case studies have shown that organizations that deal with heath and social care are striving towards achievement of good relationships among the members of these organizations (Peck, 2003).For instance, a case study of an organization referred to as Community Development Health Network, displays the importance of maintaining good relationships. The aim of the organization is to do away with health inequalities on the basis of community development approach. It can be noted from the study that community development only occurs if good relationships are maintained. These good relationships will then lead to coordination of development activities. Therefore, it is important that good relationships are maintained during quality service provision to the service users. The organization was established in 1995 and it has achieved partial goals through the emphasis on the importance of the relationship with the service users. The organization is an example of the results achieved due to good relations maintained.

Generally, maintaining good relationships in health and social care is crucial, since it will lead to quality service provision. Good relationships between the service users and the caregivers will lead to trust between these two groups. As a result, the service users will be able to confide in the caregivers. This way, the caregivers will understand the needs of the service users in a clearer way. In the end, the services provided will match with those required. Since the caregivers are agents of the organization, the same trust is transferred to the organization. Also, maintaining good relations between the organizations and the caregivers will be a motivating factor to the caregivers. As a result, they will be enthusiastic about their work. This will benefit largely the service users.Nursing Research Utilization Essay

The relationships in health and social care have greatly improved over time. This is mainly because of the participation of the society in the process of this service provision. This is evident through the already enacted Acts of Parliament in favor of these relationships. These include the Children’s Act of 1989, the NHS Community and Care Act of 1990 and the Mental Health Act among many others. The continuous participation of the government and the society has been of great significance towards enhancement of these relationships. It should be also noted that the awareness programs that are consistently implemented all over the world have played a great role in enhancement of these relationships.

In order to promote good partnerships in health and social care, local authorities should work together with the primary care trusts and other NHS members. This would enable them to contribute funds to a single pot. Eventually, they would provide better social care services. There could also be commissioning where duties are delegated from one leading company. This is already in practice for many learning disabilities. It is preferred because quality services are provided and organizational boundaries are closed.Nursing Research Utilization Essay

The implementation of the plan has to start from the top level management. The hospitals administrators should come up with a list of departmental heads that will form a task force that will head the patient satisfaction implementation plan. The task force will be mandated with the responsibility of investigating the current level of patient satisfaction in the hospital. From this evaluation, they will establish the areas that need a lot of attention and those that need slight improvements. Since it is a community hospital, they should allow feedback from the actual users of the hospital as well as the employees. After the task force has gathered adequate information about the current situation, then the report can be presented to the board of directors with a clear plan on how to achieve or increase patient satisfaction. If the workers lack motivation and, thus, have a low performance rate then they should come up with moral boosters and training programs to create awareness on the need for patient satisfaction to the organization and their role in implementation of the plan should be clearly explained.Nursing Research Utilization Essay

The board of directors would then mobilize the necessary resources required for this process. These resources may be in the form of hiring trainers who will train the hospital employees on patient satisfaction, or in the form of financial resources to conduct a survey and collect the necessary data. Monitoring of the plan could be done every six months through established sources of feedback. The task force would analyze the feedback given and through these make the necessary adjustments to the plan. Using the necessary tools of statistics the data collected by the Press Ganey Survey would generate percentile measures, which will show an increase or decrease in patient satisfaction.

The systems theory of change is a theory that views an organization as system held together by its different parts. According to this theory in order to change and to be effective all the elements of the organization must work together. A community hospital is no different from any other organization; therefore, all stakeholders (nurses, patients, physicians) should be involved in the process of change. According to this theory, the trigger for change is a conflict between the goals of the organization and those of its employees. Achieving patient satisfaction may at times be difficult for an organization because the employees may find it difficult to implement the changes in an already strenuous environment (Woodman, 1989).Nursing Research Utilization Essay

Research Methodology. Outcome Measure

The extents to which the objectives of this study have been achieved are measured through the Press Ganey top 10 variables that highly correlate with patient satisfaction (see appendix 1). Press Ganey is a firm that specializes in selling the idea of patient satisfaction to hospitals and medical centers. The top 10 variables are reached after a series of research based on patients` feedback; they are thus reliable and valid as they are not based on the theoretical view of academicians but the practical experiences of the patients. Compassion and communication rate highly in these variables.  They do not contradict the theoretical perspective of patient satisfaction. A survey conducted in 2004 including 2350 patients showed that they would consider a hospital experience pleasant if they: were treated with compassion and respect; were in constant communication with the doctors and kept up to date with their progress and efficiency of response (Safavi, 2006). Nursing Research Utilization Essay