Consumer Satisfaction in a Healthcare: Effective Leadership Rounding

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As Sphere3® has grown we have had the opportunity to bring together a really impressive team.  Over the next few months, I will be sharing posts from them that will provide helpful information for our hospital partners.  This post is written by Tanner Cook, our Blue Pants Specialist.  Tanner works with clinical leadership on how Aperum® can improve patient experience. 

“Are you satisfied with your care?”  – Said the large, yet unimposing, robotic caregiver.

In Disney’s Big Hero6, the inflatable caregiver BayMax was programmed to not only spring into action in moments of patient pain, but to follow up on the patient’s perception of his own performance.  In most cases, additional services were no longer required and the caregiver could return to his station to recharge.

BayMax and Disney know that Consumer Satisfaction is part of the Healthcare industry more than ever.  He knows that asking one question: “are you satisfied with your care?” will ensure he has met the patient’s pain management expectations.  In our world, we have more questions accompanied by regulations.  There is a line in the sand that hospital administration cannot cross when asking hospital unit leaders to survey patients.

First thing’s first, do not call it a survey!  According to CMS HCAHPS guidelines, patients should not be given any survey during their stay or at time of discharge.  In fact, “the word survey refers to a formal HCAHPS like, patient experience/satisfaction survey.”  It is permissible to ask patients questions during normal clinical or Leadership Rounds, where the leader is gathering important information about the patient perception of the delivery of quality care.

Now that we’ve identified what to call it (Leadership Rounding), we can get on to the questions.  According to the guidelines, the questions cannot resemble questions asked in the HCAHPS Survey.  Essentially, you cannot use the words “Always, Usually, Never, or Sometimes” or a rating scale “1-10.”

Some examples of questions not to ask:

  • “Did a nurse always answer your questions?”
  • “On a scale of 0-10 how would you rate your hospital stay?”
  • “Did your Doctor/Nurse explain things in a way you can understand?”

Some examples of questions to ask:

  • “Are the nurses answering your questions?”
  • “Please share with us how we could improve your hospital stay.”
  • “Was our staff attentive to your needs?”
  • “Have you had to use your call light to ask for pain medicine?

Now, you’ve identified your questions, set your sites on areas in which need improving, and be ready to have a meaningful conversation with patients in an unbiased manner that will not resemble or influence the HCAHPS Survey.   By asking targeted questions, you will find that patients will share many important, actionable, observations of your unit that you will use to make changes that will impact different experiences of future patients.

Caring is good, badgering is bad!

Sometimes we ask too many questions during rounds which can be annoying to patients and can come across as insincere.  Too many questions can also dilute focus and prioritization of actions.  While most patients DO want to share their experience, it is recommended to keep it short, focusing on two key priority areas such as pain management or responsiveness.  The leader can also ask about strategic tactics such as clinical rounds or bedside shift report.  Again, the idea is to target deficient areas of the unit and not overreach or dilute your goals.

If you choose to add “Supplemental Questions” to the actual HCAHPS Survey, they must follow the standardized HCAHPS questions and adhere to the survey protocols.  Most recommend no more than six additional questions and require that the length/complexity of the questions are not burdensome to the survey recipient.

As you can see, Disney really lightened the patient satisfaction responsibilities of Baymax.  He was too busy saving the world anyway.  In the latest effort to ensure quality care is delivered every time, “are you satisfied with your care?” is too broad of a question to cover HCAHPS’ targeted survey and is typically not enough for us all to retire to our charging stations, with all indications the patient is completely satisfied, while being rewarded our full 2% CMS reimbursement.

Tanner worked as a Transitions Navigator in one of the large hospitals in Kansas City.  He was focused on guiding families thru the hospital during one of their most challenging times.  He worked closely with clinical and hospital administration to create more patient friendly environments.   As part of the Sphere3® team, he has worked with a number of hospitals to empower clinical leadership with meaningful data to impact patient experience.

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