HCAHPS And Your Job As A Nurse
Would you like your job performance to be evaluated by:
- Someone who knows nothing about your field?
- by someone who was already in an “ill” frame of mind?
It sounds like a recipe for disaster. A train wreck in slow motion. No way anyone would let their employees be judged in this manner.
Wrong!
Nurses have the dubious honor of being evaluated just that way on a daily basis if they are working in a hospital environment.
As part of CMS (Center for Medicare and Medicaid Services) quality control, hospitals are required to have themselves graded using a 27 question survey, known as HCAHP, by discharged patients.
This isn’t some “improve customer service” flavor of the month. Nope, CMS will use the results to determine reimbursement levels to hospitals, and the information when collated is public for Joe and Jane Q Public to review. The aggregated data can be used to help us choose which hospital to use during our illness or procedure. And no, this data is not “nurse name” specific, but about the “nursing care” while patients are hospitalized. (Doctors and other staff members are subject to the same level of scrutiny.)
HCAHPS Survey Questions
A couple of the survey questions are:
- Before giving you any new medicine, how often did hospital staff tell you what the medicine was for?
- During this hospital stay, how often did nurses listen carefully to you?
If you are a healthcare professional working in this environment, you have no doubt heard of HCAHPS and may be feeling stress from your employer. Your career will be affected by how the public remembers and relays their care in your facility.
Your facility is likely to grade your continued employment on how patients in your unit answer these questions.
Why Is “Customer Service” Important In Healthcare
Your first response may be one of: “I don’t get paid enough to have to deal with stuff like this!” Or “They want me to treat every patient with kid gloves, while also expecting me to fill out 100 pages of charting on the EMR for each patient!” Or “Screw this, I’ll go be a school teacher!”
Let me suggest a better response. Use these quality surveys to help you hone your people skills.
Turn yourself into the number one salesman on your team. Become an expert in making people happy. The skills you gain here will serve you well no matter what you do in the future.
In any other career you choose your success will be partially or wholly determined by your ability to make a customer happy.
It will help you when the time comes for promotion. If you start your own business, you won’t have anyone to blame but yourself when a customer complains. Fairly or unfairly, the burden falls on you.
The skills you learn while becoming the world’s number one customer service provider will come in handy when you interview for another job. Interviewing for a scholarship to go back to graduate school? You’ll wow them with your self-confidence.
Believe me, when you can make a patient happy when you’ve just placed a catheter in their bladder, you can make anyone happy.
Now that you understand WHY you need to do this, what’s next?
You can’t just smile and nod your head and make a sick patient think you’re wonderful, can you?
Nope.
What do you do on a practical every day basis to improve your patient’s perception that you’re doing a good job?
- He doesn’t know that you put in the slickest IV catheter.
- She doesn’t know you are the nurse everyone turns to when something goes wrong.
Nope, your patient knows nothing about those things.
They only care about getting well.
They will judge you on:
- Do you care about them as a person?
- Do you do your job in a professional manor?
What can you do to improve the results of these surveys?
One thing I do, especially when I’ve had a difficult week and I have a challenging patient: I imagine them as someone else just for a moment. I might pretend they are my late grandmother whom I adored. I may think of them as someone I admire and would be honored to treat. I try to get myself into a “servant mindset.”
20 Customer Service Tips
Here are a few tips to help you on your journey to providing superior service to your customers-the patients:
- Look each patient in the eye, and alternate your focus on one eye then the other. This engages your patient and lets them know you are truly in the room with them with your mind as well as your body.
- Sit at eye level if possible when you are trying to get a history, teach, or answer questions. No one likes to be looked down upon.
- Wash or sanitize your hands on entry and exit, taking time to make sure the patient sees you. Look the part of a professional.
- Introduce yourself if it is the first time in the room or every time if they have memory problems. Give them a memory jog to help them remember you. My name is Ms Rose, you know, like the flower. Or I’m John, just like the toilet….
- Address patients by Mr. Mrs. or Ms. If they insist on being called by their first name, fine, but let them tell you.
- When you finish your mandatory Q/A on admission, make a little small talk. If you can’t at that time, explain why not and make a point to visit sometime during your shift without an agenda. Learn the art of connecting with people in a short period of time. I know some folks will talk for hours if you let them, but learn patience and how to terminate conversations with respect. If you truly have to leave urgently, let them know why in general terms, and advise them you will return later, then do it. If you are shy, ask about the weather, their family, their job. Find some way to humanize them.
- Have patients repeat what you are trying to explain to them. This will help you be certain they understood your explanation. Don’t ask yes or no questions. No one wants to seem like a dummy, so “Do you understand?” will almost always be answered with a yes, even if they have no idea what the hell you just said.
- No Medical Jargon. If you are paying attention, you’ll learn to recognize that “I don’t understand you” look. If you are always looking at your computer screen, you have no chance of connecting.
- Take ownership of problems, even if they aren’t your department. If dinner is cold, offer to warm it up. If the wrong food is sent from dietary, say you are sorry. Don’t blame someone else. There is a process for fixing system problems. If the same thing is happening over and over, don’t just complain, help look for solutions.
- If you can’t answer a question, let the patient know you will get an answer and make sure it gets followed up. Keeping a notebook with reminders for yourself will help you not forget-use a smartphone app or a simple pad and paper. “Mr Jones, that test isn’t back, but when it does come in, I will let you know.” Is much better than “I don’t know!”
- If you can’t “fix” a problem and their is truly nothing you can do about it, be empathetic, but don’t blame others. If you lay blame on others, it makes you look bad. Even if others truly are to blame, doing so will not improve the situation.
- Praise your co-workers publicly when they perform a service for others or for you.
- If you have a problem with a coworker, take it to a private room. Don’t let patients hear. Ever!
- Share with your coworkers the details about a patient and their needs. If everyone in the unit takes 30 seconds to drop in on every patient, even if they have no primary responsibility, it will make the patient feel like a VIP.
- Use your imagination for “a little act of kindness” for your patients. These don’t have to be complicated. Offer to warm up cold coffee or bring a cup for a spouse. Offer to plump a pillow or bring an extra towel. People will remember.
- When patients and families are waiting for a procedure or service, don’t give false information. If you think it will be 4 hours, say 5 and let them be surprised that it’s early. It’s sometimes easier to say, “In a little bit” or something similar when you know it’ll be all day, ’cause you don’t want to hear the complaints. People don’t like waiting, but they will respect you for being up front and honest.
- Being honest also should be your policy about anything that might hurt. That doesn’t mean telling them something is going to “hurt like hell”. Save the graphic descriptions for your novel. Be honest if a procedure is painful but give examples of how other patients have successfully managed the same procedure and lived to tell about it.
- If they’ve had a bad experience, then go the extra mile. Let them know that you understand their frustrations, and use your creativity to find some way to connect with them personally and let them know you care. Bring a flower from home, draw them a stick figure with a smiley face, offer to find their partner or family a magazine or the TV show they are looking for.
- Give words of encouragement. You can’t make a sick patient feel good about being sick. It ain’t happenin…You can let them know you care and encourage them to keep their head up.
- Smile, smile, smile. Not a smart a$$ know it all smile. You know what they look like. A genuine, I’m glad I’m here to serve you, SMILE!” Before you go into patient rooms, get into the habit of imagining something that always makes you smile. Your grandchild, your new car, the flowers in your yard, your husband or new boyfriend/girlfriend. I don’t know what makes you smile, but you do. Having a smile on your face when people see you, will make even sick folks feel better. Getting a negative thought out of your brain before you walk in that door will make you feel better too!
You may think: this is a hospital not a theater. I don’t need to “act like I care”, I just need to do my job and that should be enough. If that’s your attitude, you’re lost. You need to find another job. ‘ Cause CMS doesn’t care whether you are acting. They just want your hospital to show it provides quality care.
And yes your team members can drag you down. So be supportive of others as they learn to “show their best side at the bedside!” (yea I just made that up…)
You doing your job with enthusiasm will help your facility shine.
And it’ll give your career a boost, too. I guarantee it!
Dr Dean
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