Organizational factors impacting on patient satisfaction: A cross sectional examination of service climate and linkages to nurses’ effort and performance

https://doi.org/10.1016/j.ijnurstu.2011.04.004Get rights and content

Abstract

Background

Patient satisfaction is influenced by the setting in which patients are treated and the employees providing care. However, to date, limited research has explained how health care organizations or nurses influence patient satisfaction.

Objectives

The purpose of this study was to test the model that service climate would increase the effort and performance of nursing groups and, in turn, increase patient satisfaction.

Method

This study incorporated data from 156 nurses, 28 supervisors, and 171 patients. A cross-sectional design was utilized to examine the relationship between service climate, nurse effort, nurse performance and patient satisfaction. Structural equation modeling was conducted to test the proposed relationships.

Results

Service climate was associated with the effort that nurses directed towards technical care and extra-role behaviors. In turn, the effort that nurses exerted predicted their performance, as rated by their supervisors. Finally, task performance was a significant predictor of patient satisfaction.

Conclusions

This study suggests that both hospital management and nurses play a role in promoting patient satisfaction. By focusing on creating a climate for service, health care managers can improve nursing performance and patient satisfaction with care.

Section snippets

Background

Patient satisfaction is defined as an individual's reaction to salient aspects of their hospital care (Pascoe, 1983). It is an attitudinal response that occurs when an individual's cognitive evaluation of aspects of care meet or exceed their personal subjective standards (Crow et al., 2002). Patient satisfaction is a critical health care outcome indicator; the provision of patient centred care is an important component of a high-quality health care system. Patients who are satisfied with their

Setting and design

This study focused on units (or wards) of two government-funded hospitals in Australia. The first hospital was a tertiary hospital in a metropolitan area. The second hospital was a smaller urban hospital. These hospitals were chosen because they both had medical, surgical, and mental health services and had managers who agreed to allow external researchers to conduct research. An additional four major hospitals were approached to participate but declined because they were conducting internal

Results

Table 1 presents the means, standard deviations, and correlations among the unit-level variables. This table shows that, overall patients were satisfied with their care. Patient satisfaction was associated with nurses’ perception that there was a positive service climate, nurses’ perceptions that they direct their effort towards providing technical care and NUM ratings of task performance. On average, nurses’ perceived that the service climate was fair. Perceptions of service climate were

Discussion

This study integrated the construct of patient satisfaction into the organizational psychology literature. In doing so, we provided a unique perspective on understanding patient satisfaction. Few studies have focussed on the organizational environment or nurse performance as a predictor of patient satisfaction or the mechanisms linking the organizational environment and patient satisfaction. By focusing on how the hospital and its nurses impact on patient satisfaction, this study attempted to

Conclusion

In conclusion, we utilized the organizational and management literature to provide a unique perspective on patient satisfaction with care. We proposed and tested a multi-source model that provides management within the health care industries the potential to increase customer satisfaction. This model provides initial evidence that units where employees perceive that service is rewarded and supported have employees who engage in additional effort and, in turn, perform effectively. Such effective

Conflict of interest

None declared.

Funding

None.

Ethical approval

The University of Queensland and the participating hospitals.

Acknowledgements

We wish to thank the management, nurses, and patients at the participating hospitals, including Toowoomba Hospital, for their assistance with data collection. We also thank Andrew Neal for his comments on a previous version of this manuscript

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