title: Health care work environments, employee satisfaction, and patient safety: Care provider perspectives.
abstract: BACKGROUND
  Experts continue to decry the lack of progress made in decreasing the alarming frequency of medical errors in health care organizations (Leape, L. L., & Berwick, D. M. (2005). Five years after to err is human: What have we learned?. Journal of the American Medical Association, 293(19), 2384-2390). At the same time, other experts are concerned about the lack of job satisfaction and turnover among nurses (. Keeping patients safe: Transforming the work environment of nurses. Washington, DC: National Academy Press). Research and theory suggest that a work environment that facilitates patient-centered care should increase patient safety and nurse satisfaction.
  
  
  OBJECTIVE
  The present study began with a conceptual model that specifies how work environment variables should be related to both nurse and patient outcomes. Specifically, we proposed that health care work units with climates for patient-centered care should have nurses who are more satisfied with their jobs. Such units should also have higher levels of patient safety, with fewer medication errors.
  
  
  METHODS
  We examined perceptions of nurses from three acute care hospitals in the eastern United States.
  
  
  RESULTS
  Nurses who perceived their work units as more patient centered were significantly more satisfied with their jobs than were those whose units were perceived as less patient centered. Those whose work units were more patient centered reported that medication errors occurred less frequently in their units and said that they felt more comfortable reporting errors and near-misses than those in less patient-centered units.
  
  
  CONCLUSIONS
  Patients and quality leaders continue to call for delivery of patient-centered care. If climates that facilitate such care are also related to improved patient safety and nurse satisfaction, proactive, patient-centered management of the work environment could result in improved patient, employee, and organizational outcomes.
authors.affiliation: Department of Health Management and Informatics, School of Medicine, University of Missouri-Columbia, USA. RathertC@health.missouri.edu
authors.forename: Cheryl
authors.initials: C
authors.lastname: Rathert
authors.forename: Douglas R
authors.initials: DR
authors.lastname: May
mesh_terms: D003430:Cross-Sectional Studies; D003625:Data Collection; D005163:Factor Analysis, Statistical; D006801:Humans; D007588:Job Satisfaction; D019300:Medical Errors; D008508:Medication Errors; D009741:Nursing Staff, Hospital / Q000523:psychology*; D018802:Patient-Centered Care; D011795:Surveys and Questionnaires; D014481:United States; D017132:Workplace / Q000523:psychology