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poor patient satisfaction scores and their impact on nursing practice

The nursing challenge of patient satisfaction has gained greater attention in recent years. Apparently, nurse leaders, the issue of poor patient satisfaction has gained more concern partly because of the increasing number of health care professionals leaving small groups of practices and getting into large organizations but also because of the emphasis on patient-centered care. Nurse leaders play a significant role in addressing patient satisfaction with the healthcare organizations where they perform (Banka et al. 2015).

Nurse leaders systematically use patient surveys to evaluate patient satisfaction with numerous aspects of healthcare. The results obtained from these surveys are used to calculate scores that facilitate comparisons among nurses and other healthcare providers with the benchmarks. Patient satisfaction scores are used to determine the quality of healthcare being provided in a given healthcare facility. The significance of patient satisfaction scores has increased, and it is important to evaluate and apply them correctly.

This paper seeks to explore poor patient satisfaction scores and their impact on nursing practice. This nursing challenge will discussed in relation to challenges experienced by a well-known healthcare facility in Washington, D.C, in the United States. The healthcare facility is a 20-bed hospital that provides care to people living in Washington, D.C., and its environs. The facility has been facing poor patient satisfaction issues associated with how healthcare professionals within the hospital deliver healthcare to patients visiting this facility.

Poor Patient-satisfaction Survey Scores as a Nursing Challenge in the Nursing Facility

Nurses are primary caregivers in any healthcare system. Nurses have the closest contact with the patient and spend a lot of time examining the patient’s condition and administering treatment. The close nurse-patient contact builds up a caring relationship and significantly impacts patient satisfaction. Therefore, poor patient satisfaction scores can affect the reputation of a given facility and destroy its trust in the community it serves.

When patient satisfaction scores are shared over the Internet, the reputation of healthcare professionals is adversely affected. Some healthcare facilities also use these scores as an indicator to identify if their healthcare needs further training or if they need other forms of administrative intervention. For instance, nurses and other healthcare providers in the hospital whose patient satisfaction was below 25% were asked to meet with an expert from human services to work on improving their weaknesses. Besides, patient satisfaction scores are a central factor in reimbursement formulas as well.

Based on the perspectives of system theory, which explains the impact of smaller aspects of healthcare on the whole organization, poor patient-satisfaction scores resulting from long waiting times, poor patient safety, lack of transparent payment processing, unfriendly staff, poor telephone communication, and poor staff interaction. These adverse events can lead to numerous consequences for the whole healthcare system. For instance, poor patient satisfaction destroys the reputation of a healthcare facility, and patients can withdraw from seeking healthcare from the facility due to lost trust. Finding interventions to address such challenges encountered in nursing practice calls for nurses to establish competent leaders and leadership systems that will help maintain high patient satisfaction within the hospital. Such leaders will be able to spearhead the goals of the organizations and influence similar commitments to other health professionals within the organization.

Impact of Poor Patient-Satisfaction Score on the Organization

Patient satisfaction is an integral part of patients’ visits to the hospital. This trust can be associated with good physician and staff interactions with patients, effective telephone communication with the patients, high standards of safety and hygiene within the hospital, and fast attendance to patient issues. Besides, the hospital has been proud to maintain trust and a good reputation in the community by observing transparency in the payment systems and costs of healthcare services provided within the hospital. The hospital depends on its qualified staff to perform its duties to realize its mission and vision (Feather, Ebright, & Bakas, 2015).

However, the adverse events happening within the hospital and among its professional staff are tarnishing the reputation and trust of the facility in the community. Hanse and Winkel (2016), borrowing from the systems theory, argue that organizations have integral latent failures and weaknesses that can be detrimental to the provision of primary patient care.

Nurse leaders can ensure that there is a culture of trust and patient satisfaction by personalizing the patient experience, improving the hospital atmosphere, ensuring cleanliness in the hospital, spending time on patient education, and improving patient interactions. The system theory is used to guide the implementation of organizational change by introducing initiatives for promoting patient satisfaction within the hospital. An effective culture of personalizing the delivery of healthcare within the hospital can help in improving patient satisfaction. The culture of personalizing patient care integrates patient thinking into healthcare decisions made by nurse leaders. This joint collaboration decision-making allows healthcare professionals to recognize how poor patient satisfaction scores can affect the hospital as a whole.

SWOT Analysis of Organizational Factors

Recently, the hospital has faced a number of challenges that have led to poor patient satisfaction scores, which affect the delivery of care within the hospital. The SWOT analysis can be used to help the hospital emphasize the factors affecting the provision of care within the hospital.

SWOT Analysis


  • Personalized patient experience
  • Improved hospital atmosphere
  • Ensuring cleanliness in the facility
  • Allocating more time on patient education
  • Improving patient interactions with healthcare professionals

  • Long waiting time
  • Unfriendly staff interaction with the patient
  • Poor telephone communication
  • Lack of transparent payment processing.
  • Unsafe and comfortable hospital environment

  • Establishment of a new leadership position to oversee patient satisfaction
  • Initiating the hospital to become a Magnet hospital through the provision of quality patient care
  • Initiating patient programs to train the healthcare staff on the importance of patient satisfaction

  • Competition from other healthcare facilities
  • Lack of resources to improve the condition of the hospital.

Therefore, competent leadership is an important SWOT analysis opportunity and can be used to facilitate change within the hospital. As change agents, leaders transform plans into actions, inspire staff to remain focused on the goals of the organization, and communicate the importance of the change process to all the stakeholders within the organization.

New Leadership Position at the Nursing Facility

The new leadership that will be created within the hospital is the nurse manager. The nurse manager will be responsible for creating a healthy environment that supports nursing practice and contributes to patient interactions. The nurse manager’s role will be to influence establishing a professional environment and fostering a culture of personalized patient care. Besides, the nurse manager will also be responsible for supervising nursing staff and overseeing patient care. The American Organization of Nurse Executives (AONE) (2015) states that the nurse manager plays a critical role in optimizing patient outcomes, which forms the basis of improved patient satisfaction.

Key Competencies for the Nursing Leadership Position

The AONS outlines four leadership competencies that can help the chief nursing officer. These competencies include clinical expertise, excellent communication skills, flexibility, and managing people (AONE, 2015). By developing these qualities, the nurse manager will be able to advise members of the healthcare team whenever there is a problem and interact with physicians, patients, families, social workers, as well as other healthcare professionals. Besides, these competencies will help the nurse manager to implement changes in the healthcare organization to promote patient outcomes and increase patient satisfaction.

Impact of Leadership Power on Patient Satisfaction

Effective leadership in healthcare organizations increases patient satisfaction and improves the quality of healthcare provided. Leadership is the engine that causes change. In any organization, leaders are responsible for decisions leading to the success or failure of the organization (Gan, T. J., 2014, p.154). Decisions must be made with patient safety and satisfaction in mind. Patient satisfaction and healthcare professional engagement are intertwined. Patient satisfaction is a direct image of the type of organizational culture that the leaders have established (Banka et al. 2015, p. 498). As the engagement increases, the patient satisfaction score also increases. The significance of leadership in a healthcare organization cannot be overstated. As part of their care, patients deserve the best experience. Leadership establishes and gives direction to the organization. This motivates, encourages, and inspires the staff. Good leadership promotes staff engagement and improves the experience of patients across the care continuum.


Nurse leaders play an important role in the success of healthcare organizations, which can be measured by patient outcomes and patient satisfaction. Successful healthcare organizations demonstrate effective leadership and management that identifies weaknesses within an organization and seeks to implement possible solutions. Nurse leaders play a significant role in implementing solutions to latent organizational factors leading to adverse events within the healthcare organization. Nurse Managers communicate the organizational goals and nursing objectives to other healthcare professionals within the organization. Appreciating these nurse leadership roles and integrating them into the strategic planning within an organization helps healthcare professionals embrace changes that will improve patient satisfaction scores.


American Organization of Nurse Executives (AONE). (2015). Nurse executive competencies: Population health.

Banka, G., et al. (2015). Improving patient satisfaction through physician education, feedback, and incentives. Journal of Hospital Medicine, 10(8), 497-502.

Feather, R. A., Ebright, P., & Bakas, T. (2015, April). Nurse Manager Behaviors that RNs perceive to affect their job satisfaction. In nursing forum (Vol. 50, No. 2, pp. 125-136).

Hanse, J. J., & Winkel, J. (2016). The impact of servant leadership dimensions on leader–member exchange among health care professionals. Journal of Nursing Management, 24(2), 228-234.

Gan, T. J., Habib, A. S., Miller, T. E., White, W., & Apfelbaum, J. L. (2014). Incidence, patient satisfaction, and perceptions of post-surgical pain: results from a US national survey. Current medical research and opinion, 30(1), 149-160.



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