Best Hospitals Credit Nurses and Create Positive Workplaces


By Debra Wood, RN, contributor

pFor the last quarter century, U.S. News & World Report has annually ranked America’s nearly 5,000 hospitals to provide patients with a tool in finding skilled inpatient care, even when they require complex services. Many of the hospitals on their Best Hospitals list credit nurses with helping them receive the recognition.

“Nurses play an essential role,” said Holly Lorenz, RN, MSN, chief nurse executive at the University of Pittsburgh Medical Center (UPMC) in Pennsylvania, which ranked 12th and earned a spot on U.S. News’ annual honor roll, with very high scores in eight specialties. “What makes all of the difference and people remember is their relationship with their caregivers, particularly their nurse.”

“Exemplary nursing care is foundational to patients receiving the highest quality of care,” added Michelle Janney, PhD, RN, NEA-BC, senior vice president and Wood-Prince Family chief nurse executive at Northwestern Memorial Hospital in Chicago, which placed 10th on the list and earned honor roll status, with very high scores in 10 specialties. “Nurses are responsible for flawless execution to ensure safe and effective care.”

U.S. News considers care in 16 specialties. Its 2014-2015 Best Hospital rankings rely largely on three areas: (1) data about a facility’s structure, including the intensity of nurse staffing and designation as a Magnet hospital; (2) process, which is primarily based on reputation and a physician-centered survey; and, (3) patient outcomes.

“The literature is clear that having the right number of nurses with a higher proportion of BSN with national certifications in a positive autonomous practice environment represents the trifecta for positive patient outcomes,” said Cole Edmonson, DNP, RN, FACHE, NEA-BC, chief nursing officer at Texas Health Presbyterian Hospital Dallas, ranking high in seven specialties.

“Outcomes are where I believe that nursing can have a profound effect,” said Jeffrey I. Rohrbach, MSN, project manager for quality and safety at the University of Pennsylvania Health System. Hospitals of the University of Pennsylvania-Penn Presbyterian, Philadelphia, ranked seventh and made the honor roll, with very high marks in 11 specialties.

“The combination of an evidence-based practice model and strong collaboration with physician colleagues create an environment for optimal practice,” Rohrback added.

“It’s a team sport; recognition goes to hospitals where everyone pulls in the same direction,” agreed Anne Peach, MSN, RN, NEA-BC, vice president of patient care services at Orlando Health in Florida. Orlando Regional Medical ranked nationally in eight pediatric specialties and was high-performing in 12 adult specialties.

“Organizations that excel at providing the highest quality of care understand that it is done through teams of highly competent professionals in an environment supported by a culture and the necessary resources for teams to do their best,” Janney added.

Because nurses are at the bedside 24/7, they are keenly aware of a patient’s condition and are able to proactively respond, said Susan Green-Lorenzen, RN, senior vice president of operations at Montefiore Medical Center in Bronx, N.Y.

“Patients frequently seek medical care based on physician reputation, but it is often nursing care patients speak about when they describe their hospital experience,” Green-Lorenzen added.

“Nurses definitely contributed to our ranking,” reported Anne Marie Watkins, DNP, chief nurse executive, Kaiser Permanente San Diego Medical Center in California. “Nurses play a big role in making sure we provide a safe environment for our patients.”

Nineteen Kaiser Permanente hospitals received recognition on the U.S. News rankings, more than 13 percent of the 144 hospitals earning a spot on the list. Kaiser Permanente aims to provide a stable environment focused on the patient for nurses to practice, Watkins added.

“The best hospitals build with intentionality a culture of positive regard where nurses are valued, respected and recognized for their contributions from the bedside to curbside to the board room,” Edmonson said.

Multiple factors make a hospital a great place to practice, such as shared governance and opportunities for professional development, with support for additional degrees or certification, added Peach.

“That contributes to excellent results,” Peach said. “If you have a nurse who is board specialized in a specialty, you have a more knowledgeable nurse.”

Lorenz reported nurses want to work where they are heard and the manager and chief nurse executive trust them, care about them and allow them to own their own practice. As CNE, she strives to advocate for nurses, support lifelong learning and professional development, provide the environment that empowers nurses to problem solve and offer patients a great experience, and reward nurses who go above and beyond.

Rohrbach cited Hospitals of the University of Pennsylvania-Penn Presbyterian’s shared governance model, unit-based clinical leadership, an active clinical-advancement program, and strong and innovative leadership that foster an innovative and collegial practice model.

The opportunity to practice in a team-based environment, one in which nurses feel respected, contributes to nurses’ satisfaction with working in a top hospital, agreed Linda Franck, RN, PhD, FAAN, a professor and chair of the department of family health care nursing in the UC San Francisco School of Nursing. The University of California, San Francisco (UCSF) Medical Center, another honor roll hospital, came in at 8th place with 10 high-scoring specialties.

“The thing that distinguishes UCSF from many other hospitals is the opportunity to not only practice to the latest evidence but to be contributing to the latest evidence,” Franck said. “There is a lot of research nurses are actively engaged in.”

Montifiore staff nurses co-chair nurse practice committees driving development of evidence-based models across the organization, Green-Lorenzen added.  They also receive recognition for their extraordinary efforts.

It all comes back to nurses wanting to go home and feel good about what they did, Lorenz said. That may include having time with patients to provide education, to encourage the patient to participate in self-care and to offer hope and reassurance.

“The best nurse is the nurse who takes time to touch the patient,” Lorenz said. “The art of touch, the holding of a hand or sitting at eye level and hearing them is very rewarding. If you provide an environment where nurses feel rewarded, you will reap the benefits and so will the patients.”

View the full list of Best Hospitals for 2014-2015 ranked by U.S. News.

Would you like to work at one of the country’s best hospitals? puts you in the driver’s seat, with the chance to design your ideal nursing job.

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