Employee satisfaction and patient experience with home-visit nursing facilities: A facility-level analysis

Employee satisfaction (ES) may influence patient experience, but facility-level evidence remains limited. This study examined the association between facility-level ES and Net Promoter Score (NPS)-based patient experience in home healthcare settings. This cross-sectional study included 87 home healthcare facilities. Questionnaire responses from 1,066 staff members underwent exploratory factor analysis, yielding four ES factors whose scores were aggregated to facility-level means: management integrity and governance, supervisor and workplace support, organizational pride and identification, and goal orientation and continuous improvement. Patient experience was assessed using NPS data from 6,615 survey responses. Multiple linear regression analyses examined facility-level NPS, promoter proportion, and detractor proportion. Detractor proportion was significantly associated with ES factors (p = 0.028); goal orientation and continuous improvement was negatively associated, whereas management integrity and governance was positively associated. Organizational factors related to goal orientation and continuous improvement were associated with lower detractor proportions. These findings suggest that specific dimensions of employee satisfaction may be more relevant to reducing negative patient evaluations than to increasing positive recommendations. However, the findings should be interpreted cautiously because only detractor proportion was significantly associated with employee satisfaction factors.