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Achieving Kaiser Permanente quality.

Matthew D McHugh1, Linda H Aiken, Myra E Eckenhoff

  • 1Matthew D. McHugh, PhD, JD, MPH, RN, FAAN, is The Rosemarie Greco Term Endowed Associate Professor in Advocacy, Center for Health Outcomes Policy Research, University of Pennsylvania, Philadelphia. E-mail: mchughm@nursing.upenn.edu. Linda H. Aiken, PhD, RN, FAAN, is The Claire M. Fagin Leadership Professor of Nursing, Center for Health Outcomes and Policy Research, University of Pennsylvania, Philadelphia. Myra E. Eckenhoff, BA, is a research assistant at theCenter for Health Outcomes and Policy Research, University of Pennsylvania, Philadelphia. Lawton R. Burns, PhD, is James Joo-Jin Kim Professor, Wharton Center for Health Management and Economics, University of Pennsylvania, Philadelphia.

Health Care Management Review
|July 2, 2015
PubMed
Summary

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Kaiser Permanente

Area of Science:

  • Healthcare Management
  • Nursing Science
  • Organizational Behavior

Background:

  • Kaiser Permanente's integrated health delivery model is recognized for quality and efficiency.
  • Attempts to replicate Kaiser's success have largely failed.
  • Nursing's role in organizational culture and patient care may explain Kaiser's advantage.

Purpose of the Study:

  • To investigate the contribution of Kaiser's nursing organization to healthcare quality.
  • To compare patient and nurse outcomes in Kaiser hospitals versus non-Kaiser hospitals.
  • To assess if nursing differences explain outcome disparities.

Main Methods:

  • Cross-sectional analysis of linked secondary data from 564 adult general acute care hospitals (2006-2007).
  • Inclusion of a detailed nurse survey.

Related Experiment Videos

  • Logistic regression models to analyze patient (mortality, failure-to-rescue) and nurse (burnout, job satisfaction, intent-to-leave) outcomes.

    • Main Results:

    • Kaiser hospitals demonstrated significantly better patient and nurse outcomes than non-Magnet hospitals.
    • Kaiser hospitals excelled in nurse work environments, staffing, and BSN-prepared nurses.
    • Nursing differences accounted for a substantial portion of Kaiser's outcome advantage.

    Conclusions:

    • Investment in professional nursing is a key factor in Kaiser Permanente's success.
    • Hospitals can improve care processes and outcomes by investing in nursing, potentially through Magnet designation.
    • Magnet designation offers a proven, cost-effective strategy for enhancing nursing and patient care.