Never. Sometimes. Usually. Always. These are the four ratings that patients can give hospitals on each of 27 questions on the HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) Survey.
The goal is “Always.” To have patients who always feel listened to. To have patients who always are well cared for. To have patients who will always recommend your hospital or facility.
HCAHPS has changed the game in healthcare in recent years. Public reporting of survey results has inspired hospitals to continually raise the bar on quality of care, and for good or ill, the survey itself has become a focal point for improvement over the past decade and particularly in the last year or so.
There are three main reasons that the pursuit of excellence in patient satisfaction has become one of the top goals for hospitals:
- Patients are now empowered with metrics to compare hospitals directly.
- Hospitals with the highest HCAHPS scores have been proven to have better business results.
- Hospitals with top ratings are reimbursed at a higher rate from Medicare.
So, what is the secret to raising patient satisfaction and scoring high on HCAHPS? Experts say success lies in first raising employee satisfaction levels. In fact, both Gallup and Towers-Watson have found a direct and significant correlation between high employee engagement and high patient satisfaction. A 2005 JHACO study echoes this, finding a strong correlation between employee morale and patient satisfaction.
I would take this even a step further and say success lies in creating a culture of satisfaction in healthcare, both for employees and for customers. Here is a few ways in which a strong recognition program can contribute to creating that culture.
Raise Employee Engagement
Raising patient satisfaction requires massive amounts of engagement from staff. Generally speaking, engagement is not a problem in the healthcare industry—where workers are among the most dedicated and committed of any industry. But high burnout, stress and turnover rates among caregivers also means you neglect engagement at your peril. Strategic recognition has been proven to drive engagement and job satisfaction.
Encourage Better Communication
Of the ten HCAHPS measures that are publicly reported on the Hospital Compare Website for each participating hospital, fully SIX have directly to do with communication. Yet hierarchy, internal fiefdoms and strained labor relations can make communications a challenge. Make sure you’ve created an environment in which everyone feels empowered to speak up, innovate and recognize great behavior.
Help Reduce Mistakes & Increase Patient Safety
In addition to the HCAHPS surveys, another important metric for excellence lies in patient safety. Safety is always improved when there is improved communication and heightened awareness. Recognition can help build the relationships and teamwork that encourage critical communication, and encourages team work and awareness of peer activity. Recognition also drives engagement, which is another important factor in safety. A study by Gallup has linked higher nurse engagement to reduced patient mortality, and at least one study has shown a rise in engagement scores has been proven to help reduce patient falls by 81% and medical errors by 32%. Cultures in which people have great communication and engagement are environments in which fewer mistakes are made.
According to the HPOE (Hospitals in Pursuit of Excellence), it is critical that “each team member, clinical and non-clinical, must understand what their role is in creating an ideal experience for patients and should be provided with the appropriate tools and training to support their work.” A focus should be on identifying the activities that drive satisfaction, and on encouraging everyone to take ownership in that activity. HPOE reports one leader from a high-performing hospital saying “Don’t focus on the scores; focus on tasks that affect the scores.”
Encourage Enthusiasm and Positivity
One unfortunate byproduct of HCAHPS is it has put a lot of stress on an already stressful job. Healthcare workers pour heart and soul into their work, and it is important to avoid emotional burnout by re-filling the coffers of goodwill, offering lots of positive feedback and creating an environment that is filled with support and positive feedback. This keeps smiles on the faces of happy, rewarded employees, and at the end of the day, a simple smile and positive outlook can go a long way toward patient satisfaction.
As the HPOE has noted, to be successful in raising HCAHPS numbers: “Leaders must motivate staff to continue to focus on the patient. They need to recognize and reward patient-centered behaviors.” In fact, here is HPOE’s recipe for an engaged workforce in support of HCAHPS excellence:
- Staff members are recruited for patient-centered values and job descriptions, including patient-centered description of responsibilities
- Orientation and ongoing training reinforce patient-centered tools and skills
- Patient-centered care is rewarded and celebrated
- Caregivers are supported when challenging situations arise with patients/families:
- Staff are actively involved in designing patient-centered care processes
- Accountability and incentives support patient-centered care
Recognition is not just a way to retain and engage employees. It is good for those things, yes, but concentrating on recognition and reward is also a great way to get everyone on the same page and encourage a culture that will keep both employees and patients happy—and keep your metrics full of “Always.”
And along these lines, we’d like to wish all of you a happy Nurses Week and send a big message of appreciation out to the nurses out there who bring so much comfort and healing into our lives (including my own mom and stepmom!). Thank you for your compassion, skill and dedication!