| BONUS
CONTENT FROM LPN2007
10
steps to improve patient satisfaction
Mark A. Zen Ruffinen, RN, CMSRN, MS
Are you proud of your facility?
Would you like to make it even better? If you answered yes,
consider joining the grassroots nursing effort to improve
patient satisfaction.
I’m a staff nurse in
a 30-bed medical/surgical unit at a Magnet hospital. Shortly
after receiving my RN license, I joined our unit patient-satisfaction
committee. Over the next 2 years, our committee worked passionately
to initiate culture changes needed to provide consistently
great care, as rated by our patients. From our experience,
we developed 10 steps to achieve top patient-satisfaction
ratings.
Step 1. Participate
in a patient-satisfaction committee. If your
facility or unit has a committee, join it. If not, invite
coworkers who are interested to help you form one. Also
consider inviting those who don’t seem as interested
to help sell them on the idea.
Our committee consists of five
RNs (including the nurse-manager), an LPN, and two certified
nursing assistants (CNAs). The CNAs provided very valuable
information on the delivery of direct patient care.
Step 2. Focus on
customer complaints. Take one general complaint
a month and fix it. In our first month, we focused on answering
the call bell in three rings or less. We communicated our
focus for the month at the monthly staff meeting and committee
members conducted informal teaching sessions with fellow
staff members. At first, answering the call bell was burdensome
for staff, but we soon realized that meeting patient needs
quickly led to more satisfied patients and caregivers alike.
Step 3. Set realistic
goals. Goals will guide your work. If any
practice or procedure is a hindrance, rethink and redo to
align it with unit goals. Our committee set six aggressive
goals for our first year:
- Exceed the 90th percentile
in patient satisfaction every month.
- Rank first in patient satisfaction
of all inpatient units at our site.
- Focus on monthly improvement.
- Become the benchmark unit
for patient satisfaction within our hospital—the
unit that others consider to have the best practices.
- Document all efforts to
improve.
- Become the unit of choice
for physicians at our hospital.
Step 4. Get buy-in.
Not everyone will be ready to improve patient satisfaction
when you are. A major task may be to convince reluctant
coworkers that patient satisfaction is right for them, the
patients, and the facility.
To get the staff on board with
our goals, our committee sponsored a mandatory patient-satisfaction
fair for all unit staff. For example, one poster topic was
AIDET, which stands for Acknowledge the patient and her
family, Introduce yourself, Duration (how long you’ll
be there that day), Explanation of any tests or procedures
being done that day, and Thank you. Even the hospital CEO
attended. After this event, we hit the 90th percentile in
patient satisfaction 2 months in a row for the first time.
Step 5. Identify
high, medium, and low performers. High performers
give more positive energy to their patients and others.
Low performers tend to bring everyone down.
Ideally, all staff should be
high performers, but low and medium performers can also
improve their performance. Committee members modeled high
performance by using AIDET principles, avoiding negative
talk, answering call bells quickly, and reinforcing other
positive behaviors.
Step 6. Welcome
your patients. We print “Welcome to
3 Tower” signs on standard 8½ x 11-inch paper
and place them in rooms before a patient arrives. Each caregiver
writes her name on the sign. At discharge, we send the sign
home with the patient to show that we still care.
Step 7. Publicize
your patient-satisfaction efforts. If your
facility monitors patient-satisfaction scores, post your
scores monthly for all to see. If not, post patients’
positive comments. We placed signs in the halls with our
monthly score. When our unit scores reached the 99th percentile,
we added: “Care is BEST in the nation.”
Step 8. Make callbacks
without fail! In a follow-up phone call, you
can reinforce the positive feelings that a patient had for
the staff and care received during a hospital stay, elicit
suggestions for improvements, and gather stories of excellent
care to encourage caregivers.
Step 9. Support
other committees working to improve patient care.
In one 3-month period, at least six committees worked in
our unit to improve care delivery. For instance, one hospital-wide
committee streamlined the delivery process. This work resulted
in many simultaneous changes, which reduced staff and patient
satisfaction for 3 months. But we didn’t give up.
At our second annual patient-satisfaction
fair, we correlated patient-satisfaction scores with improvements
to our unit. In response, one nurse wrote: “Seeing
all the changes we made all in one place at one time brings
home how much we have really accomplished. At the time we
were making changes in different areas all at once, it was
overwhelming. Now that it’s over, I’m glad we
did. This floor has come a long way and now I love it!”
Step 10. Be on
the lookout for the next great idea. New ideas
may come from coworkers, TV, books, magazines, or elsewhere.
Our “Welcome to 3 Tower” sign was an improvement
on an idea from another unit. In addition, we’ve adapted
many ideas from Hardwiring Excellence, a book devoted
to improving patient satisfaction in health care.
Our results
Our patient-satisfaction mean score has increased from an
average of 82 in the early 2000s to nearly 90 in 2006, we’ve
reached the 99th percentile for 3 months in 2006, and we’ve
been over the 90th percentile in all but 2 months. With
sustained effort, you too can do great things for patient
satisfaction.
Reference
Studer Q. Hardwiring Excellence: Purpose, Worthwhile
Work, Making a Difference. Gulf Breeze, Fla., Fire
Starter Publishing, 2003.
Source: Nursing2007. May 2007. |
