Nurse Engagement and the Patient Experience



The American Organization of Nurse Executives (AONE) annual meeting was full of inspiration and great thought leadership. Among those presenting was Christina (Christy) Dempsey, CNO of Press Ganey. Christy’s talk went right to the heart of the link between nurse engagement and the patient experience and was supported by the rich data for which Press Ganey excels. Catalyst Learning summarizes this interesting presentation for our newsletter readers as food for thought during Nurses Week 2016.

Employee Engagement Matters to the Patients

The graph below illustrates:

  • the top 20% (green) and bottom 20% (blue) of Employee Engagement in a set of 52 projects studied by Press Ganey;
  • the average rating on HCAHPS domain (bottom axis) for these high and low engagement organizations.

Clearly, the magnitude of engagement has a significant impact on patientexperience and HCAHPS rating, with high performers ranging from 62-74% and low performers ranging from 20-40% on the individual domains.

A deeper dive into the top 3 drivers of likelihood to recommend resulted in an interesting perspective:

  1. Teamwork (across every service)
  2. Nurse Courtesy
  3. Cleanliness of Patient Room

Christy shares the common theme of these drivers: they make the patient feel safe – safe from mistakes; safe from infections; and safe because their RN has demonstrated empathy and compassion.

Employee Engagement Matters to Employers

We briefly discussed how the engagement of your RNs can affect the patient experience and we know that HCAHPS scores translate to reimbursement. Now let’s see how lost productivity is just one more way that employers are hurt by a lack of engagement in their nurses.

As the infographic demonstrates, 15 of every 100 nurses is disengaged. Each disengaged nurse costs $22,200 in lost productivity. For a 400 bed medical center, that spells $1.6 million annually!

Ah, but what about the cost of a disengaged nurse leaving your organization? If you were thinking that might be a relief, it actually costs $44,380 to replace each nurse vacancy, according to Press Ganey’s data. CLC’s research uncovered other credible studies which report the turnover cost of an individual nurse can range from $33,000 to $56,000.

Christy made some excellent concrete and practical suggestions to positively impact both nurse engagement and patient satisfaction. She also encouraged the nurse leaders in attendance to lead by example.

Behaviors that can be done very quickly during everyday interactions with patients include:

  • Acknowledge patient suffering: “I’m sorry your head hurts.”
  • Body Language: Practice sitting down when you meet with your patient.
  • Coordinated Care: Show patients that they are not going to ‘slip through the cracks.’
  • Care Transcends Diagnosis: Don’t treat patients like the ‘Heart Cath in room 204’. Sit down and spend a few moments on introductions when you first meet.


These data suggest that organizations seeking to improve their patient experience scores should think carefully about the state of nurse engagement. For those who already know their nurses aren’t as engaged as you need them to be, perhaps this has inspired you to think about what you will do to help your nurses feel fulfilled and energetic. And for those who believe all is right and well, feel free to share with us what you are doing right and light the way!