I have noticed that organizations who underperform financially may struggle to maintain quality care and patient safety, thereby resulting in less patient centered care

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I have noticed that organizations who underperform financially may struggle to maintain quality care and patient safety, thereby resulting in less patient centered care due to compromises they make to be able to afford to keep the lights on. Hospitals who are able to perform financially have more freedom to invest in various quality improvement projects. This can result in safer quality care, setting them apart from other institutions which perpetuates their image as an organization in which patients can rely on for their care and bringing in more patients.

As I have advanced in my career I do not thing these factors have changes in any way. I do think that they affect organizations because nurses do not want to work in organizations in which safety and quality have been compromised out of fear of loosing their licenses. Better performing institutions can afford to pay nurses a more competitive wage, makes them more desirable and pulling in more experienced nurses.

I do not think these factors will change in the future. I agree with out textbook when it states that part of the issue is that there is not enough well qualified nursing leaders at decision making tables throughout organizations to bring up safety and quality issues (Sherwood & Barnsteiner, 2017). Organizations who are struggling may benefit from brining in highly respected, experienced nursing leaders to complement physician members and strengthen clinical input (Sherwood & Barnsteiner, 2017).

I think these factors are changing very slowly. An analysis found that the essence of nurses and physician leaders have down disproportionally over the last ten years. Nursing leadership grew 2-6% while physician representatives grew 14-26% (Sherwood & Barnsteiner, 2017).

Sherwood, G., & Barnsteiner, J. (2017). Quality and safety in nursing (2nd ed.). Wiley.