NEW YORK NURSE: April 2010
by Randi Hoffman
Health care is not an assembly-line industry, say RNs at Brooklyn Hospital Center, so employees shouldn’t be evaluated as such.
Yet, the hospital’s CEO wants a “pay for performance” program that ties nurses’ salaries to the results of patient satisfaction questionnaires.
“Pay for performance” is an emerging movement in industry and health care in Great Britain and the United States, and a popular subject in business schools. General Electric and several car manufacturers have used this incentive pay proposal, but it hasn’t been proven effective in healthcare.
“It’s just proposed,” said Joyce Cave-Anderson, bargaining unit grievance chair. “We’re at the negotiating table. They haven’t given us anything concrete. But they don’t seem to have the foggiest idea of how this would be accomplished.”
Cave-Anderson said she has never seen any kind of actual patient survey. “Pay for performance would apply to everyone, but they’re mostly focusing on nurses. NYSNA is being very proactive in opposing this.”
“They say, ‘we’ll give the nurses X amount of dollars if the patient satisfaction scores go above X value,’” explained Roberta Murphy, associate director of NYSNA’s Economic and General Welfare Program. “The problem is that, if the scores go down, they could try to take money away.”
“It’s really about staffing,” Murphy added. “The only way to improve outcomes is to have sufficient nursing staff. But that costs money that the employers don’t want to pay.”
“It’s an inner-city Brooklyn hospital that’s understaffed, short of supplies and full of old and broken equipment,” added NYSNA Labor Representative Elaine Charpentier. “They pay the lowest nurses salaries in Brooklyn.” She said the concern is that, if patients are given the survey, they won’t understand that the hospital is understaffed and underfunded, and might blame the nurses for conditions beyond their control.
“Pay for performance is not proven to improve patient outcomes or increase patient satisfaction,” Murphy added. “More nurses per patient is what makes patients happy with their care, because then they receive more of the nurses’ time and energy.”
The RNs at the Brooklyn Hospital Center have been without a contract since June 30, 2009. More than 350 nurses picketed the hospital on July 1, 2009, the day after the contract expired. The nurses have met with local legislators, spoken at community board meetings and leafleted the community. They have placed advertisements in local newspapers about the short-staffing issue.