As a nurse who has been practicing for almost ten years, the changes I've seen in the way we take care of our patients are dramatic. At the beginning of my career, I felt I was able to make a difference in my patients lives on a daily basis. When I left floor nursing and took a job in diabetes education, I did so because I felt that I could no longer provide adequate care because of staffing discrepancies and an administration who cared more about the almighty dollar than about the welfare of their patients – not that I blamed them, because they were forced to, along with most other hospitals in our country.
“If your employees are satisfied and they really like their job, they're going to treat their patients well, which will increase patient satisfaction and the quality of care they're providing.”
Sonora Regional Medical Center
There are a variety of tools to measure patient satisfaction scores. One such tool is the Hospital Consumer Assessment of Healthcare Providers and Services (HCAHPS) assessment tool, which measures patient satisfaction for all types of inpatient populations. For example, a patient who was hospitalized for heart failure may be asked if their nurses discussed side effects of their medications, if their room was an adequate temperature, if their environment was quiet and conducive to rest and if their food was hot when it reached their room.
I don't find there to be inherently anything wrong with the questions on the HCAHPS patient satisfaction tool. In fact – I think the information gleaned on the tool can be utilized in great ways. For example, if the majority of the patients complain that their food is cold, obviously we know that, hey, guess what? There is room for a process improvement in the food service. If most of the patients note that they do not know the side effects of new medications, again, there is a necessary education component for nursing.
However, it has been drilled into the staffs' heads that when patient satisfaction scores are low, reimbursement from Centers for Medicare & Medicaid Services (CMS) decreases. When reimbursement decreases, this seems to cultivate a culture of decreased morale. After all, hospital management must discuss the patient satisfaction scores and decreased reimbursement with the staff. When there is decreased reimbursement, there is often decreased room for necessary increased staffing, which equates to increased overtime, and no room for new equipment. These can decrease staff satisfaction.
What happens then? It ends up being a never-ending cycle – low staff satisfaction equals low patient satisfaction. Ten years ago, we did collect patient satisfaction scores but our administrations had not yet lived and died by those scores.
So, what's my recommendation?
I may be a lowly RN but I do have enough education and work experience to give my two cents. I have worked for administrations and managers who have valued my work and it has been enough to say that being valued matters. Being valued on a daily basis make me want to work hard for my patients.
I would urge hospital administrators to use the patient satisfaction scores as a guide. Use the negative comments as a learning experience. More importantly, give thanks for every single positive remark that is received. Celebrate the victories. Remember that the staff is the backbone of every facility – keeping the staff happy will keep the patients happy.