Taking Care of the Right Pressure: A Dynamic Theory of Health Care Work Pressure, Nurses Well-being and Patient Satisfaction

摘要

To hospitals it is of great importance to maintain and increase health care performance, especially with respect to patient satisfaction. Currently, work pressure is a crucial factor to a hospital's reputation, as well as to its employee's well-being and quality of care. System dynamics (SD) modeling is used to better understand the interaction among patient satisfaction and work pressure among nurses, based on literature review and a case study research of the nursing-cardiology unit of HNL Hospital. This area of research covers many already known causal relationships but leading authors point out a lack of dynamic implications and effects over time. This research addresses the complex causal feedback mechanisms responsible for changes in work pressure, employee well-being and patient satisfaction over a time span of ten years. Through an iterative process a quantitative SD model is built. The results suggest a fragile edge between a sustainable high workload and escalation, which might only appear after years of working under too much pressure. It proofs to be most cost effective to provide more support in the work of nurses at earlier stages of symptoms of increased work pressure.