Yesterday I spoke with a nurse who called to tell me a 'funny story.' She had just left a mandatory staff meeting where the nurses, secretaries, nursing assistants and others on her unit were called together to talk about the hospital's brand.
At the meeting she learned that the health system where she works wasn’t stacking up when it came to patient satisfaction scores. Which is concerning, considering that they are consistently recognized on Top 100 lists and are a Magnet hospital, to boot. So throughout the organization, work teams and units were being called together to learn that the hospital’s brand stood for ‘excellent patient care’ and that a comprehensive initiative was being undertaken to improve HCAHPS ratings.
At first, she told me, everyone nodded their heads. “Great,” a colleague said, “we’ve got a lot of ideas for how we can provide better care.” Recommendations eagerly popped out -- such as better collaboration and communication between the ER and the unit to create seamless hand-offs during the admission process, adjusting staffing to provide more support during the labor-intensive periods when new admits come on the unit, and assuring adequate supplies so that nurse could stay at the patient bedside rather than wander around the building to find basic patient care necessities.
Another nurse brought up concerns about four separate patient safety issues and suggested they discuss how those could be avoided in the future. “But wait,” says the meeting chair, “we’re not here today to talk about patient safety, we here to fix our patient satisfaction scores.”
My friend reported that she then noticed the managers and speakers at the front of the room shaking their heads as each suggestion from the floor was raised. “We can’t do that at this time.” “The ER will never change their practice regarding transfers.” “This isn’t what we’re here to do today.”
So what was the point of the meeting? To be instructed in the art of scripting. “Hello, Mrs. Jones, here at (anonymous) hospital, we’re committed to excellent patient care.” “I hope you found your care excellent.” “Is there anything else I can do for you for your care to be excellent?” And so on.
The whole theory, of course, being that the more they drop the word “excellent” within patient earshot, the more likely patients are to check off the “excellent” box on the satisfaction score sheet.
The rest of the shift, she reported, the nursing staff would jab and make comments to each other such as "I'm sorry to be three hours late giving you your meds tonight because the order was confused - but we give excellent patient care."
Now I have to believe that this was not the intent of the initiative, nor the intended outcome of the meeting, but something seriously got lost in translation. When the nursing team hears that it’s the patient satisfaction score and not the patient care that needs improving – well, I’m not laughing.
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