Controlling The Epidemic Of Outrage
Outrage is one of those human emotions that when used sparingly is useful to separate the most egregious violations of social norms from the constant background of minor social violations....
A blog for and about medical directors
Last month, Christy Dempsey, the Chief Nursing Officer of Press Ganey, visited our medical center to discuss strategies hospitals can use to improve patient satisfaction. She had some really insightful comments. Improved patient satisfaction doesn’t just improve your hospital’s scores on the Medicare Hospital Compare website, but it also results in lower length of stay and lower readmission rates.
The 3 most important factors that affect inpatient satisfaction are (1) a perception of teamwork, (2) nursing courtesy, and (3) cleanliness. From the patient’s perspective, “teamwork” = “safe work”. For cleanliness, it doesn’t necessarily mean brand new & spotless; instead, patients think of “clean” as “safe” so patients will perceive your hospital as being clean if they feel that they are safe in the hospital. Some of the simple things that you can do that will improve patients’ perception of cleanliness include:
The 3 most important factors contributing to patient loyalty in the outpatient setting are: (1) confidence in the provider, (2) the providers work well as a team, and (3) communication.
In the hospital, patients want to perceive that the doctors and nurses exhibit compassion. There are 6 key ways that your staff can do this:
One of the toughest questions on the HCAHPS survey relates to the hospital being quiet at night. As providers, we equate “quiet at night” to mean “noise at night”. But for the patient, “quiet at night” means “minimal interruptions at night”. Make sure that the staff minimize waking the patient up at night by coordinating nocturnal vital sign checks to happen at the same time as their nighttime IV antibiotic dose. If your hospital practice is to draw routine daily labs at 4:00 AM… then stop. Try to give the patient as much uninterrupted sleeping time as possible each night.
Another HCAHPS survey question that hospitals struggle with is pain control. Be sure that the doctors and nurses set patient expectations for pain control and that the pain score goal is not a “zero” – patients are going to have pain if they are post-op or admitted with fractures and the goal is not to completely eliminate their pain but instead to make the level of pain tolerable. In this sense, your staff have a lot more influence on pain control than your medications do.
Communication with the patient by both doctors and nurses are also a part of the HCAHPS survey. Taking a few seconds to learn something about the patient other than their disease and symptoms can make a big difference in how the patient perceives communication. Do they have grandchildren? What are their hobbies and pastimes? Where did they grow up? Communication with the patient can be improved with scripting but don’t script the exact words, script the sentiment. It is important, however, avoid faking emotions since this will cause burn out in the nurses and physicians. Unfortunately, you can’t teach compassion – you either have it or you don’t so it is important that you identify compassion in nurses and doctors when they are first applying for their jobs.
Remember:
Improved patient experience is not only good for the patient, but it is good for your nurses and doctors. For example, nurses job satisfaction correlates better with patient experience than with staffing adequacy. A favorable work environment correlates with fewer patient falls and pressure ulcers than the staffing in that environment.
April 12, 2017