New study reveals performance-based financial incentives may not improve nurse staffing

Feb 4 2011

A new study, conducted by Ellen Kurtzman, R.N., M.P.H., FAAN, assistant research professor in the GW School of Nursing, and published in Health Affairs reveals that while nurses have been recognized as pivotal players in improving hospital quality, including that which is driven by performance-based financial incentives, linking reimbursement to quality of care goals could weaken the nursing workforce and threaten the nursing practice environment.

"This research has given us an unprecedented opportunity to be in the field and interview hospital leaders and unit nurses about the impact of performance-based incentives. While nurses are not typically considered in the design of such incentive programs, our study indicates that they influence the implementation of such policies and are impacted—in some cases negatively—by these programs. Overall, interviewees reported favorable effects of financial incentives on patients but viewed these emerging policies as burdensome to nurses and having little positive effect on improving nurse staffing or turnover," said Kurtzman.

The study, funded by the Robert Wood Johnson Foundation, was part of a larger, two year research project to examine the impact of performance measurement, public reporting, and performance-based financial payment policies on nurses. These findings are among the first to describe hospital stakeholders' attitudes and perceptions of federal transparency and accountabilities policies on hospitals, nursing practice, and the nursing workforce.