It should come as no surprise that while hospitals might be in the business of providing the best medical care, they are also in the business of hospitality and customer service. And now, with the inception of the HCAHPS survey, hospitality and customer service means more for hospitals than ever before. HCAHPS, or more colloquially referred to as “h-caps” stands for Hospital Consumer Assessment of Healthcare Providers and Systems. What this means is that upon discharge, patients are randomly selected to rate their time at the hospital in 21 categories. These categories range from doctors’ communication, nurse attention and the noise level in the hospital. In fact, based on patient ratings, Hospitals can have 2% of their medicare payments added or withheld as of 2017.
“Reimbursements are increasingly tied to quality outcomes, and HCAHPS scores have quickly become a critically important identifier that can benchmark quality from a patient point of view,” said Marcia Faller, PhD, RN, Chief Clinical Officer for AMN Healthcare. Hospitals that provide a higher quality of care receive reimbursements and hospitals that provide a lower quality of care will be penalized. Thus, patient satisfaction can ultimately make or break a hospital. Healthcare leaders have an even more pressing interest in protecting their hospital and to improve patient experience, it is best to go straight to the front lines, those who have 24/7 influence on patient experience: Nurses.
New research has revealed the strong, direct impact that staff engagement has on HCAHPS scores. A recent study found that the facilities with the highest employee engagement (top 10%) scored an average of 61% higher on the HCAHPS Overall Hospital Rating metric. This has healthcare leaders raising their voices about the connection between staff satisfaction and patient satisfaction. Tony Armada, CEO of Advocate Lutheran General in Chicago sums it up well, advising: “I would urge health care leaders to understand that patients going forward will have more choice than ever, and it is best to serve our patients with a group of people that are dedicated and engaged.”
A recent Press Ganey research paper found that nurses’ work environment is a key driver of a hospital’s overall performance. Further, the report found that patient experience, as measured by HCAHPS scores, is significantly correlated with RN hours per patient day. In fact, this study also concluded that the nurse work environment is significantly related to all HCAHPS patient satisfaction measures. Additionally, it found that patient-to-nurse workloads were associated with patients’ ratings and recommendation of the hospital to others.
Two employee engagement strategies that can improve patient satisfaction include implementing the correct staffing and managing nurse overtime. The ability to staff correctly is important for staff satisfaction and retention. A Nursing Economics article argued, “When nurses are exposed to inadequate staffing levels, they leave their positions. The impact of overtime starts with a drain on labor costs. More importantly, extensive overtime takes a toll on employees”. Another study solidifies the relationship between longer shifts and nurse reports of professional burnout and job dissatisfaction.
Another simple way to improving nurses’ work environments is to make sure their equipment is up to date and working correctly. The BlackJack magnetic breakaway cable helps to ensure the connection between the nurse call unit and the patient's’ hospital bed. The ease of use of the cable allows each nurse to ensure that the patient is being taken care of without taking any more time away from their already busy schedule. Taking no more time than a blink, nurses can ensure that beds are securely hooked up to the nurse call unit, and will not be harassed by unnecessary alarms later in their shift. And with better nursecall connectivity comes decreased patient falls, which in turn leads to better HCAHPS scores.
Overall, improving nurses’ work environments, including nurse staffing, managing overtime and making sure their equipment works correctly, seems to be the key to improving the patient experience and quality of work. Because, ultimately the more positive the relationships between patients and nurses are, the better the patient experience will be.