Patient Satisfaction? A Matter of Perception

June 26, 2012
William Balfour

Make Excellent Patient Satisfaction a Reality

healthcare data analyticsPerception is reality ” debatable in life, but the golden rule of patient satisfaction.  The patient’s perception of care is – for the purposes of HCAHPS – reality.  Your hospital and staff are clinically excellent, your outcomes good, yet your patients may perceive you as too busy to care, coolly detached or lacking in compassion.  How can you change this perception?  iVantage hospitals weigh in on mindsets and strategies they’ve employed to improve patient satisfaction.

Communication.  Communication.  Communication.

Healthcare is a relationship and communication is the cornerstone of every successful relationship.  Encourage staff to communicate one-to-one with patient and family members; everyone should introduce themselves by name and role to patients and family; and ask and use the patient’s preferred name.  Scripting or practice conversations ensure the use of key words at key times.  All staff should ask patients and families, “Is there anything else I can do for you?” before leaving a patient.  Whiteboards, hourly rounding, bedside shift change, and proactive expectation management are examples of inclusive patient and family communication that raise scores.

Hand-off with Care

Hand-offs and transfers are ripe for communication mix-ups and lost information, causing the patient to feel less secure in your care.  Manage patients’ expectations of a trip to Radiology or the lunch schedule by communicating likely scenarios and making sure to personally introduce the patient to staff in the ancillary areas such as Imaging.  To increase patient satisfaction at shift changes, staff should introduce the staff coming onto the next shift.  TM Nurse hand-offs tend to be successful when done at the patient’s bedside and the patient is included in their own care plan.  Pros of bedside reporting include:

    • Patient meets new staff through someone with whom they are familiar
    • Maintains a team approach to care
    • Enables a more thorough report and clarifies patient condition
    • Patient becomes part of the care team and can add important information
    • Provides patient with a sense of security knowing that everyone has the same information

Round and Round

Management (administration and nursing) rounding can have a dramatic effect on patient satisfaction.  Patients understand that their perceptions are important when management and/or nurse leaders take the time to speak with them. During rounding, explain your hospital’s patient satisfaction goals, and ask what needs to be done to accomplish them.  This both provides valuable information and increases patient awareness of staff efforts. If a patient does not receive rounding, make a post-visit call and collect any feedback the patient would like to offer.

Where’s MY Nurse? 

Nurse continuity is a patient satisfier, but it’s often not possible to maintain complete nurse continuity throughout the entire patient stay.  In many hospitals, continuity is generally maintained manually by reviewing past daily assignments and assigning the same nurses to patients. In addition, utilizing 12-hour shifts help minimize staff changes.  Ideas iVantage partners use to mitigate shift and staffing changes:

    • Whiteboards for nurse/CNA names and shift times
    • Have charge nurse explain the personnel change ” staffing, schedules, skill sets, etc.
    • Ask if the change is acceptable to the patient
    • Introduce replacement RNs and extenders at the end of each shift and when a nurse leaves the floor for lunch

Manage Expectations, Impressions and, well \”¦ Everything

Proactive expectation management can be the difference between a positive hospital stay and getting slammed on the Patient Satisfaction survey. Will there be construction? A long wait in Radiology? Discharge delays? Sometimes unpleasant news is unavoidable but if patients are informed ahead of time, they will generally be more accepting of the delays and rate the hospital more highly.

    • Sorry is smart – Apologize for any delays or mistakes that occurred. An apology goes a long way towards mitigating negative patient perceptions.
    • Last impressions – Make sure that your discharge process includes a caring and compassionate discussion of post-hospital needs and utilize scripting when appropriate. Ask and make note of what patients thought about their interactions with staff and physicians.

Staff are Key to Enhancing Perception

    • Call Buttons ” Decrease call button use by proactively rounding; analyze your call button response times to identify issues with time-to-response.  Institute a “No Pass” rule wherein no hospital staff member passes by a call light without inquiring if they can help.
    • Share results with staff, often – Patient satisfaction scores and responses should be discussed openly and frequently at meetings; results posted publically.
    • Work in the moment “ When nurses or staff are in the patient room, encourage them to take the time to devote their full attention and thinking to that specific patient.
    • Hire compassionate people – Ask situational interview questions regarding dealing with difficult patients.  Be mindful that leaders are role models for new staff.
    • Keep staff happy – Employee satisfaction leads to patient satisfaction.
    • Be aware of, and proactively manage, compassion fatigue – A nurse with compassion fatigue may see a minor and reasonable patient request as rude and demanding

Perception.  Reality.  It’s all the same to your patients.  Successfully manage patients’ perceptions of your excellent care and watch your HCAHPS score – and your patient satisfactionTM soar.

iVantage partner hospitals have contributed these ideas, and hundreds more, to the iVantage KnowledgeWeb, a peer collaboration platform and best practice library. TM 

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