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.
Keywords: friendly workplace; healthcare quality; treatment of nursing staff.
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