Using relationship marketing to develop and sustain nurse loyalty: a case of a rural health care institution

The prosperity of a health care organization is contingent on its ability to compete for and retain a high quality staff of "loyal" nurses. Although the benefits of maintaining a loyal nursing staff are obvious, turnover in the health care industry is dangerously high. One solution for reducing turnover is to develop and sustain a loyal nursing staff. The purpose of this article is to apply customer-oriented marketing theories and practices to better understand how strong nurse-provider relationships can be developed and maintained over time. The authors first examine relationship marketing literature as it applies to nurse relationship and management issues. Second, a framework for conceptualizing internal marketing efforts devoted to enhancing nursing staff satisfaction and retention in tested. Finally, strategies for practicing relationship marketing will be provided.     

人性化护理打造便捷就医服务流程

目的通过发挥医院护理人员的优势,推进"流程便捷化、环境温馨化、服务人性化"便民利民措施,为患者提供温馨、便捷、安全的服务。方法开展多项创新服务项目,贯穿于院前-院时-院后的连续服务中,以营造人性化服务的整体氛围。结果提高了护理服务质量和护士素质,提高了患者的满意度和忠诚度。结论实行人性护理服务,充分发挥护理人员的主观能动性,注重服务全过程中给予护理服务对象人性关怀,可以收到满意的效果。     

Service quality: A subliminal pathway to service differentiation and competitive advantage in private healthcare marketing in Ghana

The study investigates the role of service quality in Ghana’s private hospitals and its effect on patients’ satisfaction and loyalty. A sample of 622 respondents was drawn using convenience sampling. Structural equation modeling using smart PLS was used to test the measures. The study found a significant positive relationship between service quality and patient satisfaction and also a significant positive relationship between patients’ satisfaction and loyalty and that patients’ satisfaction mediates the relationship between service quality and patients’ loyalty. The study provides a useful guide to policy formulation for private healthcare practitioners.     

Customer convergence: patients, physicians, and employees share in the experience and evaluation of healthcare quality

This article explores the interrelationships between three categories of service quality in healthcare delivery organizations: patient, employee, and physician satisfaction. Using the largest and most representative national databases available, the study compares the evaluations of hospital care by more than 2 million patients, 150,000 employees, and 40,000 physicians. The results confirm the relationship connecting employees' satisfaction and loyalty to their patients' satisfaction and loyalty. Patients' satisfaction and loyalty were also strongly associated with medical staff physicians' evaluations of overall satisfaction and loyalty to the hospital. Similarly, hospital employees' satisfaction and loyalty were related to the medical staff physicians' satisfaction with and loyalty to the hospital. Based upon the strength of the interrelationships, individual measures and subscales can serve as leverage points for improving linked outcomes. Patients, physicians, and employees, the three co-creators of health, agree on the evaluation of the quality of that service experience. The results demonstrate that promoting patient-centeredness, enhancing medical staff relations, and improving the satisfaction and loyalty of employees are not necessarily three separate activities in competition for hospital resources and marketing leadership attention.     

Customer Convergence

This article explores the interrelationships between three categories of service quality in healthcare delivery organizations: patient, employee, and physician satisfaction. Using the largest and most representative national databases available, the study compares the evaluations of hospital care by more than 2 million patients, 150,000 employees, and 40,000 physicians. The results confirm the relationship connecting employees' satisfaction and loyalty to their patients' satisfaction and loyalty. Patients' satisfaction and loyalty were also strongly associated with medical staff physicians' evaluations of overall satisfaction and loyalty to the hospital. Similarly, hospital employees' satisfaction and loyalty were related to the medical staff physicians' satisfaction with and loyalty to the hospital. Based upon the strength of the interrelationships, individual measures and subscales can serve as leverage points for improving linked outcomes. Patients, physicians, and employees, the three co—creators of health, agree on the evaluation of the quality of that service experience. The results demonstrate that promoting patient—centeredness, enhancing medical staff relations, and improving the satisfaction and loyalty of employees are not necessarily three separate activities in competition for hospital resources and marketing leadership attention.     

Current marketing practices in the nursing home sector

Marketing is widely recognized as an essential business function across all industries, including healthcare. While many long-term care facilities adopted basic healthcare marketing practices and hired marketing staff by the early 1990s, a paucity of research on nursing home marketing exists in the literature. This study examines the extent to which nursing homes have developed more formulated marketing and related communication and promotional strategies as market competition has increased in this sector during the past two decades. In addition, we explored managers' perceptions of their control over marketing decision making, the impact of competition on the use of marketing practices, and areas for enhanced competitive positioning. Administrators from 230 nursing homes in 18 Southeastern Michigan counties were surveyed regarding (1) the adoption level of approximately 40 literature-based, best-practice marketing strategies; (2) the types of staff involved with the marketing function; and (3) their perception of their level of control over marketing functions and of local competition. Results from 101 (44 percent) survey participants revealed that although respondents viewed their markets as highly competitive, their marketing practices remained focused on traditional and relatively constrained practices. In relation to the importance of customer relationship management, the majority of the administrators reported intensive efforts being focused on residents and their families, referrers, and staff, with minimal efforts being extended to insurers and other types of payers. A significant positive relation was found between the intensity of marketing initiatives and the size of the facility (number of beds), whereas significant negative correlations were revealed in relation to occupancy and the perceived level of control over the function.     

Internal Marketing and the Antecedents of Nurse Satisfaction and Loyalty

Employee satisfaction and retention are critical issues that influence the success of any organization. Yet, one of the most critical problems facing the worldwide health care industry is the shortage of qualified nurses. Recent calls have been made within the traditional nursing literature for research that utilizes marketing and business models to better understand nurse satisfaction and retention. The purpose of this study is to develop scales that can be used to empirically test a model of the proposed antecedents of nurse job satisfaction and loyalty which have been used widely in the internal marketing and the relationship-marketing literature. Specifically, the study will investigate the degree to which structural bonding, social bonding, financial bonding activities, and quality of care impact how well nurses are satisfied with their job and their commitment to the organization. The results show that quality of care most impacted nurse satisfaction and loyalty, followed by structural, social, and financial bonds.     

某院儿科护理工作满意度调查分析

目的 了解患儿家属对儿科护理工作的满意度情况,为提高护理工作质量提供科学依据.方法 通过自行设计《2012年兰州大学第二附属医院儿科护理工作满意度调查表》,收集患儿家属对儿科护理工作的满意度情况,用统计描述、X2检验等方法对儿科护理工作满意度的多个方面进行分析.结果 调查对象性别差异不具有统计学意义.不同年龄调查对象对护理服务的便利性和服务态度方面差异具有统计学意义（P ＜0.05或P＜0.01）,其它方面无统计学差异（P＞0.05）.不同收入水平调查对象对护士站环境、关爱沟通和健康教育方面差异具有统计学意义（P＜0.05或P＜0.01）,其它方面差异不具有统计意义（P＞0.05）.结论 树立“以人为本”的护理服务理念,提高护理服务的便利性,做好协调沟通,注重关爱沟通,加强健康教育,以提高护理服务满意.     

A person-centered workplace: the foundation for person-centered caregiving in long-term care

OBJECTIVE: This study seeks to understand what role managers and the work setting they create play in a nursing facility that seeks to make a transition to person-centered care. DESIGN: The study uses a human-relations framework to test 3 propositions: Managers play a critical role in the satisfaction, loyalty and commitment (ie, the engagement) of their staff; managers construct a person-centered workplace that deepens staff engagement; and engaged staff promote the well-being of the residents. SETTING AND PARTICIPANTS: The study draws on responses of Certified Nurse Assistants (CNAs) and families of residents collected in 2 satisfaction surveys conducted in 156 nursing facilities. It also uses state inspection survey data from the same facilities. MEASUREMENTS: The analysis uses measures of satisfaction, loyalty, and commitment as well as 6 scales of quality; 3 as they pertain to staff and 3 as they pertain to families. Data reduction, correlational, and risk analyses assess how managers and the work environment affect CNA engagement and the quality of caregiving. RESULTS: Management approach and the work environment are powerful predictors of CNA satisfaction, loyalty, and commitment. The work environment also correlates with how families and state surveyors evaluate quality in a nursing facility. CONCLUSION: The managers and the work setting they create hold primacy in the work life of the CNAs. Caring managers fashion a person-centered workplace conducive to turn workers into devoted caregivers. When the workplace adds quality to the life of caregivers, the caregivers add quality to the life of the resident.     

2015年-2017年全国三级医院护理质量分析

目的分析2015年-2017年我国三级医院护理质量现状,为质量持续改进提供依据。方法从国家护理质量数据平台提取2015年-2017年护理质量相关数据,分析各指标数据的变化情况。结果（1）截止2017年,所有指标的完整性均超过98%。（2）床护比、护患比与24小时平均护理时数3项指标3年均保持相对稳定。（3）2015年-2017年三级医院本科及以上护士占比增长明显,3年增加8.12%;5年及以上年资护士占比稳步提升,3年增加5.36%;2015年-2017年三级医院护士离职率稳步下降,3年下降0.24%。（4）2015年-2017年三级医院住院患者身体约束率中位数分别为1.38%、1.36%、1.60%,呈现波动变化,2017年增长较为明显。（5）护士执业环境中的“医院管理参与度”“薪酬待遇”与“社会地位”等维度得分较低。结论（1）经过两年护理敏感质量指标理念与数据收集的培训,三级医院护理质量指标数据变异度逐渐减小,数据完整性与可靠性得到提升;（2）护理人员绝对数量的增加并未改善护理人员相对不足的现状;（3）护理人力结构得到优化,队伍稳定性增强;（4）约束、跌倒等指标逐年升高,侧面印证了数据上报文化逐步形成和数据逐渐趋于真实与可靠;（5）护士执业环境测评结果表明,薪酬待遇及社会地位是制约护理行业的关键因素。     

护士长在神经内科绩效考核中的管理职能分析

在医院管理系统中,最主要的管理岗位中包括护士长职务,护士长面临的任务和承担的责任在临床管理中发挥着及其重要的作用,其作用有利于建立良好与和谐的科室,护士长在绩效考核中发挥着管理职能,保证科室能够正常运转。绩效考核可以提升护理工作质量和水平,提高患者满意度,从多方面满足患者的需求,激发护理人员的创新性、工作潜能、自主学习能力、提高护理人员的上进心。通过绩效考核鼓励护理人员工作的积极性,提高工作效率,使其保持良好的工作状态。同时,为护理人员创造了公平、公正、公开的竞争平台,并且还能调动每个护理人员的工作积极性和主动性,从而提高患者及患者家属的满意度,护理人员的综合素质得到提高。在该次研究中,研究护士长在神经内科绩效考核中的管理职能,为医院同行提供更多的参考意见。     

绩效考核在口腔医院优质护理服务中的应用

目的探讨绩效考核在口腔医院优质护理服务中的应用,调动护理人员工作积极性和主动性,提高护理工作质量。方法建立护理绩效综合评价体系,制定具有口腔专科特色的绩效考核标准,将绩效管理与量化管理集合起来,实行护理部、科护士长、护士长三级考核管理负责制,考核过程中准确把握可操作性和公正性的考核原则,对护理质量进行控制,并进行反馈,考核结果与奖金挂钩,并作为年度考评的依据,能使护理管理规范化、合理化。结果护士工作主动性增强,护理质量检查合格率提高,个人原因引起的护理差错降低,患者、医生对护理人员的满意度上升,投诉率及护患矛盾的比例也大幅下降。结论绩效考核的实施充分调动了口腔专科医院护理人员的工作积极性与主观能动性,提高了患者、医生满意度,深化了优质护理服务,提高了护理队伍的整体素质。     

The all-RN staff: why not?

The emphasis on cost containment and consumer satisfaction has spurred a new upsurge in interest in all-RN nursing. Data are mounting that show that an all-RN staff doesn't necessarily cost more and that its use markedly improves the quality of patient care. Although obstacles to implementation exist, they are not insurmountable, and nurse leaders are asking, "Why not?"     

Nurses in the community: a manpower study.

High priority is at present being given to the expansion of health visiting and home nursing services as part of the change of emphasis from institutional to community care. The aim of this study was to provide nurse managers in two regional health authorities with basic information about community nurses with could be used for service planning and development. The results of the study emphasise the particular problems of staffing the community nursing service in inner London, where home nurse and health visitors are younger, more recently appointed, and relatively less experienced than staff in other parts of the regions. High turnover rates and chronic recruitment difficulties in inner London prevent nurse managers from maintaining both the level and the quality of the services they aim to provide. Until these problems are remedied there is little prospect of achieving any significant shift in the balance of care in inner London.     

The impact of Regional co-payment and National reimbursement criteria on statins use in Italy: an interrupted time-series analysis

Background

Japan has the highest aging population in the world and promotion of home health services is an urgent policy issue. As home-visit nursing plays a major role in home health services, the Japanese government began promotion of this activity in 1994. However, the scale of home-visit nursing agencies has remained small (the average numbers of nursing staff and other staff were 4.2 and 1.7, respectively, in 2011) and financial performance (profitability) is a concern in such small agencies. Additionally, the factors related to profitability in home-visit nursing agencies in Japan have not been examined multilaterally and in detail. Therefore, the purpose of the study was to examine the determinants of financial performance of home-visit nursing agencies.

Methods

We performed a nationwide survey of 2,912 randomly selected home-visit nursing agencies in Japan. Multinomial logistic regression was used to clarify the determinants of profitability of the agency (profitable, stable or unprofitable) based on variables related to management of the agency (operating structure, management by a nurse manager, employment, patient utilization, quality control, regional cooperation, and financial condition).

Results

Among the selected home-visit nursing agencies, responses suitable for analysis were obtained from 1,340 (effective response rate, 46.0%). Multinomial logistic regression analysis showed that both profitability and unprofitability were related to multiple variables in management of the agency when compared to agencies with stable financial performance. These variables included the number of nursing staff/rehabilitation staff/patients, being owned by a hospital, the number of cooperative hospitals, home-death rate among terminal patients, controlling staff objectives by nurse managers, and income going to compensation.

Conclusions

The results suggest that many variables in management of a home-visit nursing agency, including the operating structure of the agency, regional cooperation, staff employment, patient utilization, and quality control of care, have an influence in both profitable and unprofitable agencies. These findings indicate the importance of consideration of management issues in achieving stable financial performance in home-visit nursing agencies in Japan. The findings may also be useful in other countries with growing aging populations.     

实施整体护理后健康教育中的问题与对策

目的为了提高护理人员开展健康教育的质量。方法采用问卷对４所三级医院的４００名护理人员进行调查。结果９６４％的认为健康教育很重要；８３０％的认为健康教育是医生和护士的共同责任；８８３％的人选择病人与家属进行健康教育；８４１％的选病人入院至出院间开展健康教育；５９５％的人未接受开展健康教育的培训；４９４％的人的健康教育知识是通过阅读专业图书获得；８５２％的感到健康教育知识缺乏。结论护理人员在健康教育中做了大量工作，但多数人缺乏系统和规范的健康教育知识及对教育效果缺乏评价指标等。因此，应从３个方面采取措施。     

"The nurse satisfaction,service quality and nurse retention chain": implications for management of recruitment and retention

This paper presents the findings of a qualitative study, based on interviews with over 130 nurses and midwives in four London Trust hospitals on: the main factors influencing nurse satisfaction and retention; empirical support for the robustness of a conceptual framework or model "the nurse satisfaction, service quality and nurse retention chain"; and some managerial considerations for recruitment and retention. The three main factors influencing job satisfaction were patients, the inherent characteristics of nursing and the nursing team; the two main sources of job dissatisfaction were staff shortages and poor management and amongst nurse retention strategies improving working conditions was more important than increased pay. For recruitment, as well as retention, improving the image and reputation of nursing along with improvements in work-life balance were pre-requisites for meeting the challenging target of an additional 20,000 nurses on the wards by 2004.     

The aging nursing workforce: How to retain experienced nurses

In the face of an anticipated nursing shortage, healthcare organizations must evaluate their culture, operations, and compensation system to ensure that these elements align with organizational efforts to retain nurses who are approaching retirement age. Management should focus on enhancing elements of job satisfaction and job embeddedness that will motivate nurses to remain both in the workforce and with their employer. Although much of this responsibility falls on the nurse manager, nurse managers are often not provided the necessary support by top management and are neither recognized nor held accountable for nurse turnover. Other retention initiatives can include altering working conditions to reduce both physical and mental stress and addressing issues of employee health and safety. As for compensation, organizations may be well-served by offering senior nursing staff flexible working hours, salary structures that reward experience, and benefit programs that hold value for an aging workforce.     

基于360°考核法的军人门诊护士绩效考核管理

目的探讨360°绩效考核法在军人门诊开展优护理服务中的应用效果。方法运用delphi专家咨询法及360°绩效考核的管理理念,根据科室服务对象、服务项目、护理岗位、护理质量、护理安全等的不同,构建全方位、多维度绩效考核指标及评价体系,每周不定期检查考评护理人员的工作质量,每月结合科室责任项目管理、责任小组管理、科务工作、劳动纪律的评价,通过量化汇总评分,评出绩效考核第一护理人员,并给予奖励。结果和结论 360°绩效考核方法充分调动了护理人员工作积极性,达到了促进护理工作质量的持续改进的目的,也为护理人员的评选、晋升、奖惩提供依据。     

应用6S管理模式提高临床护理管理质量的有效性分析

目的探讨分析应用6S管理模式提高临床护理管理质量的有效性。方法选择2017年8月—2018年12月收治入院的相关患者62例,随机数字表分为对照组(n=31)和观察组(n=31)。对照组给予常规护理管理模式,观察组在常规护理管理的同时应用6S管理模式(整理SEIRI、整顿SEITON、清扫SEISO、素养SHITSUKE、安全SECURITY),比较两组护理管理质量情况和两组患者对护理人员的综合素养的评价。结果观察组患者对基础护理、病房管理、医院感染、护理安全、治疗室安全的评分情况均高于对照组,差异有统计学意义(P<0.05)。观察组患者对护士仪表、健康教育、服务态度、护士技能水平的评分均明显高于对照组,差异有统计学意义(P<0.05)。结论将6S管理模式用于提高临床护理中,能提高临床护理管理质量,提高护理人员的综合素养。