Nursing leadership visits for real-time patient experience enhancement: a cross-sectional study of tertiary hospital care in Brazil

护理领导层巡视对实时提升患者体验的影响:一项针对巴西三级医院的横断面研究

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Abstract

BACKGROUND: The quality of hospital care and patient experience are pillars of healthcare delivery. Nursing leadership visits have emerged as a management strategy to monitor and enhance these aspects in real time. The objective of this study was to evaluate nursing leadership visits as an instrument for measuring the quality of hospital care provided in a philanthropic tertiary hospital in São Paulo, Brazil. METHODS: This retrospective study analyzed data from Nursing Leadership Visits conducted from July 2023 to December 2024. Initially, the institutional database contained approximately 8,500 records. A total of 7,707 eligible Nursing Leadership Visits were included, excluding visits performed by nurses not in leadership positions. Data were summarized using absolute and relative frequencies (%), in addition to descriptive statistics (mean, standard deviation, median, minimum, and maximum) for Likert scale variables. Patients were classified as promoters (score 9 or 10), neutrals (score 7 or 8), or distractors (score 0 to 6) on the basis of the net promoter score. No inferential analyses were performed. RESULTS: A total of 7,707 eligible Nursing Leadership Visits were analyzed. The average net promoter score calculated from these visits was 95.6%, with 97.07% of patients classified as promoters, 2.78% as neutrals, and 0.16% as distractors. The average process and environment compliance rate was 97.6%. Nursing management interventions were required in 1,293 (16.78%) of the visits, with 767 (59.32%) of them being resolved during the visit itself. The analysis of patient experience dimensions demonstrated that, while high scores predominated, the instrument was capable of identifying areas for improvement, especially in the evaluations of neutral and distractive patients. CONCLUSION: The reformulated Nursing Leadership Visit is an effective and indispensable instrument for managing the quality of hospital care. Its implementation fostered an evidence-based management approach, facilitating strategic decision-making and contributing to the establishment of a culture of continuous improvement through immediate intervention and a focus on real-time patient experience. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12912-025-03989-8.

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