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About Diane Kay Boyle PhD, RN, FAAN

Improving Patient Outcomes by Examining Nursing Work Environments
For over 20 years, I have been leading improvement of the nursing work environment, nursing workforce, and patient safety through (a) expertise in developing and evaluating standardized, value-driven metrics; (b) building collaborative research teams; and (c) sustained investigation of relationships between nursing and patient outcomes. My work includes contributions in two major impact areas.
Impact Area 1: Development and evaluation of performance metrics within the National Database of Nursing Quality Indicators (NDNQI), a program of Press Ganey [formerly a program of the American Nurses Association (ANA)]. I spearheaded collaborative initiatives to expand NDNQI metrics to include standardized measures of nursing turnover, the nursing work context, nursing national specialty certification, and perinatal unit staffing (in collaboration with the American Association of Women’s Health, Obstetric, and Neonatal Nurses). In collaboration with ANA, I headed evaluation of metrics such as nursing skill mix and injury falls in order to maintain National Quality Forum (NQF) endorsement as national consensus performance standards. The impact of this work is nearly 2,000 U.S. hospitals receive reports based on standardized data that are actionable at the patient care unit level — identifying where quality improvement plans and nursing workforce improvement plans should be focused.
NDNQI fall measures are included in the Measure Applications Partnership’s best metrics for injuries from immobility (for public and private sector reporting and performance based payment systems, as required by the Affordable Care Act). The fall measures are used in the Centers for Medicare and Medicaid Services’ Partnership for Patients Hospital Engagement Network initiative to reduce hospital-acquired harm by 40%.
Impact Area 2: Research linking the nursing work environment and nursing workforce characteristics with nurse and patient outcomes. I have (a) led a collaborative research team in examining the relationship between quality of nurse leadership and nurse – physician (N-P) communication with staff nurses’ job satisfaction, intent to stay, and perceptions of patient outcomes; (b) tested an NIH, National Institute of Nursing Research-funded intervention to improve N-P communication; (c) co-led a team testing an intervention to improve nurse manager leadership and communication; and (d) co-led a team examining the effect of the built-environment on N-P communication. My colleagues and I found that the quality of nursing leadership and N-P communication significantly influences outcomes and that N-P and nurse manager communication can be improved through training. Publications from these studies have been cited nearly 500 times. My research team also has established links between the nursing work environment, nursing workforce characteristics, and patient outcomes. For example, we found high unit RN turnover in one calendar quarter was associated with increases in pressure ulcer rates in the subsequent quarter and higher RN hours per patient day (RNHPPD) were associated with lower pressure ulcer rates.
I now head a collaborative team (funding: Wyoming IDeA Network of Biomedical Research Excellence; NIH, NCRR & NIGMS) that is developing a novel composite quality performance indicator of pressure ulcers and falls. I also am part of a team that is examining the relationship between nursing specialty certification and surgical site infections (funding: Competency and Credentialing Institute).


Present Professor of Nursing, University of Wyoming

Curriculum Vitae

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Contact Information

Fay W. Whitney School of Nursing
University of Wyoming
1000 E. University Ave, Dept. 3065
Laramie, WY 82071


Bayesian Psychometrics (3)

Nurse-Physician Communication and the Built Environment (1)

National Nursing Specialty Certification and Patient Outcomes (1)