Nurses play a huge role in Hospital Consumer Assessment of Health Care Providers and Systems (HCAHPS) scores. Last year, a study released by Press Ganey Associates highlighted nurse communication as a “rising tide measure” that, if enhanced, would likely raise HCAHPS scores in other areas, too, including:
As in any relationship, good communication is fundamental to positive nurse-patient connections (and subsequent HCAHPS scores). Try integrating these phrases into your regular patient encounters to maximize the patient experience—and the ratings your patients are giving.
Before entering a patient’s room, knock, and then ask permission to enter. Although “May I come in?” may seem superfluous, the question conveys consideration—something a patient might not be feeling much of amid flimsy gowns and other perceived indignities of hospital stays.
“Asking for permission [to enter] suggests a matter of respect for the patient,” said Quint Studer, coauthor of The HCAHPS Handbook: Hardwire Your Hospital for Pay-for-Performance Success.
Upon entry, introduce yourself and explain why you are there—to the patient as well as others in the room, Studer advises. If visitors are present, be sure to obtain permission from the patient before discussing personal health information.
By referring to patients by names that are preferable and comfortable to them, you are again extending respect and awarding a bit of power at a seemingly powerless time for patients.
After nurses at Crozer-Chester Medical Center, Chester, PA, began asking this question and jotting the answer on a white board in the room for others to reference (in addition to implementing other communication interventions), they saw 5-8% gains on their units’ HCAHPS scores.
You can call that a success.
Nothing invites quality back-and-forth like an open-ended question—one that is impossible to answer with a simple “yes” or “no.” When it comes to directions, medications, and discharge plans, open-ended questions give patients the floor to communicate even minor issues or inquiries that, if left unanswered, could lead to major consequences down the road.
Reword questions that start with “do” to begin instead with “what” or “how.” Smile, and look the patient in the eye when you ask it. Such small efforts have the potential to reap big responses.
Before you leave for the day, introduce your patients to the nurse who will take over. Bedside shift reporting is a biggie for enhancing patient satisfaction.
“Instead of giving report in the staff conference room, they do it right here and include me,” remarked one pleased patient. “I was able to tell the next shift what was working and what wasn’t. It was so nice to see them working together and, even better, that they included me.”
Bedside reporting gives patients a voice in nurses’ conversations. It encourages teamwork. And it cuts down on errors. HPCHPS score!
Kristin Baird, a patient experience consultant with the Baird Group, has noticed something peculiar about hospitals. Through elegant aesthetics and efficient front-end processes, many work hard to make a good first impression on patients. But when it’s time for patients to go home, they—in her words—“completely blow it” with a lackluster, “Looks like we have everything we need. You’re free to go.”
Don’t fizzle at the finale. Upon discharge, thank them for using your hospital. See what questions you can answer. Offer to round up a wheelchair, and find someone to help tote the patient’s belongings to the car.
One hospitalist even suggests small health-promoting gifts—such as pedometers or calorie counters— to motivate patients to follow discharge plans and to leave them with a lasting good impression.
“If you are giving patients something that is useful for health,” he said. “I would argue that you are doing more for the patient experience than putting a fountain in the lobby.”