Unions and Hospitals: Is There A Quality and Patient Satisfaction Difference?

There are numerous and diverse efforts aimed at increasing both the quality of care and patient experience in hospitals. To date, much of the research has identified the importance of clinical guidelines, pathways, protocols, streamlined processes, electronic health records, and the implementation of quality management techniques from other industries like the airlines industry.

Recently, there has been integration between health services researchers and quality/patient safety researchers seeking to identify empirical factors at the level of the individual, group, and organization that predict a culture of safety and ultimately quality clinical and patient experience outcomes. To date, there is a dearth of literature on the role of bargaining units and its influence on such outcomes. However, there have been a few regional studies that have demonstrated a statistically significant relationship between the presence of unions and reduced mortality rates.

The purpose of this session is to describe the design and findings of an investigation which examines the empirical relationship between the presence of unions, the presence of direct patient care unions, and union density on mortality rates as measured by the 30-day AMI mortality rate and overall patient satisfaction as measured by HCAPS score controlling for hospital type [teaching vs. community; public vs. private] and hospital size. The potential contribution of this investigation is that it will be the first national study and will offer various stakeholders empirical evidence regarding the impact of unionization in hospitals on two key outcomes: mortality and patient satisfaction.