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Patient Satisfaction

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by

Jeannine Melllish

on 20 November 2013

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Transcript of Patient Satisfaction

Shhhhh.....
Education....
Why it's important for everyone
improves patient outcomes
improves HCAHP scores
Focuses on the "E" in the AIDET mnemonic
Patient Satisfaction
Patient Education
Noise



What type of education do healthcare consumers think essential?
In a study completed in 2011, 100% of patients surveyed rated the following as
essential:
Education/information:
When to follow up with doctor and warning signs
Medicines for post hospitalization
Even more important than:
Treatment received
Side effects of meds
(Shoeb, Merel, Jackson, & Anawalt, 2012)


What do our patients want for education?
86.5% wanted verbal discharge
84% wanted to be given reading information (97% requested brochures)
67.5% identified education about lifestyle changes as the most important part of education
(Shoeb et al., 2012)

Patient Satisfaction
What keeps our patient's satisfied?
Criteria for patient satisfaction
How do we define patient satisfaction?
*We measure the patient's perception of their hospital experience.
Communication
-Nurses and Dr's
*Meds, procedures, disease processes
Discharge info
Pain
Timely Help
Overall Rating
Ways to Improve
Maintain good communication upon admission to discharge
-Nursing communication makes the biggest difference
Assess for pain every hour, interventions used, and outcomes
Hourly Rounding
AIDET
-Acknowledge, Introduce, Duration, Explaination, Thank you
Positive compassionate attitudes
Related Nursing Factors
Staffing
Skills mix (%RN, %BSN)
Magnet vs. Non Magnet
NDNQIvs. Non-NDNQI
Overall work environment
Patient Questions
Rate the hospital/your stay overall?

Would you recommend this hospital to friends/family?

How often...
-do nurses communicate well?
-does staff explain medications given to you?
-was the patient's pain well controlled?
-do patient's receive help quickly?







How does noise affect our patients?
In one study only 56% of patients reported that their room was "always" quiet (Haupt, 2012)
Nightingale's environmental studies
She felt that intermittent noise was far worse than continuous noise and that little annoyances build up and cause stress and anxiety for the patient (Morton, 2013)
Grossly affected healing
Patient Response to Noise
Sleep deprivation
Sleep less, take longer to fall asleep, & awaken more frequently at night
Become more sensitive to noise
Decreased pain tolerance
Decreased immune response
Delayed wound healing
Increased heart rate & respirations
Increased risk of ischemic heart disease & hypertension
Delirium in ICU patients
Staff Response to Noise
Impaired cognition
Decreased concentration
Increased stress
Increased risk of medication errors
Increased risk of burnout
Sources of Noise
Staff
Visitors
Alarms
Computers
Telephones
IV pumps
Televisions
What can we do?
Identify sources of noise
Find out the patient perception
The Hospital Environment composite of the HCAHPS survey
Close doors
Eliminate overhead paging
Earplugs, eye masks, or music
Coordinate patient care activities together to decrease disruptions
Dim the lights
Manage visitors
Sound meters at nurse's stations
Connect the dots on why we care about noise
Quiet Time
A designated time (usually an hour) in the hospital to decrease noise and allow patients to rest
Studies show that this boosts patient satisfaction scores
Lights dimmed & doors closed
Try to make the patient comfortable before Quiet Time
No tests, therapy, overhead paging, visitors, or deliveries from gift shop
Signs posted
Follow Up & Finances
Once efforts have been made, a post-implementation hospital-based survey can provide insight to how well the measures taken are effective.
Best to make it similar to the HCAHPS survey
Better healing can lead to patients going home earlier & less readmissions
RN's
Unit/Nursing Assistants
Respiratory Therapists
Physicians
Lab Tech
Nursing Students
**Any other hospital staff that come into contact with patient

Target Audience

HCAHPS
...Hospital Consumer Assessment of Healthcare Providers and Systems
What is it?
-Nationally recognized survey of patient's perspective

What does it do?
-Provides comparable data
-Incentives
-Public Accountability
Nurses and Doctors
Respectfulness
Active/Open Listening
Explanations


**Highly influential on overall rating
Communication
Meds
Written down
Purpose
Changes
Directions
Follow-up Instructions
Who, When, Where, Why
Adequate assistance at home

Answer questions
Discharge Information
Pain
Very Important!!!

Was it well controlled?
How often did the staff help with your pain?

**Think...
-Hourly Rounding
-Follow-up after giving med
-Communication
Staff Response
**Responding to patient's needs in a timely manner


**Think Quick...
-to the bathroom
-call light response

Overall experience
Recommend
Actual Rating or Grade

**Think
-Alignment
-Consistency
-Accountability
Overall Rating
References

Allender, J.A., Rector, C., & Warner, K.D. (2014). Community and public health nursing: Promoting the public’s health (8th ed.). Philadelphia: Lippincott Williams & Wilkins.

The American Nurses Association. (2013). About NDNQI. Retrieved from http://www.nursingquality.org/About-NDNQI2

Bombard, C. (2009). HCAHPS is all about patient satisfaction. Nurseweek (15475131), 16(9), 22-27.

Haupt, B. (2012). Instituting Quiet Hour improves patient satisfaction. Nursing, 42(4), 14-15.

Kutney-Lee, A., McHugh, M., Sloane, D., Cimiotti, J., Flynn, L., Neff, D., & Aiken, L. (2009). Nursing: a key to patient satisfaction. Health Affairs (Project Hope), 28(4), w669-w677. doi:10.1377/hlthaff.28.4.w669

Morton, J. (2013). Notes on noise. Nursing, 43(5), 37-40. doi:10.1097/01.

Murdock, A., & Griffin, B. (2013). How is patient education linked to patient satisfaction?. Nursing, 43(6), 43-45.

Pennsylvania Patient Safety Authority. (2010). Leveraging Healthcare Policy changes to decrease hospital 30-day readmission rates. Pennsylvania Patient Safety Advisory, 7(1), 1-8.

Shoeb, M., Merel, S., Jackson, M., & Anawalt, B. (2012). "Can we just stop and talk?" patients value verbal communication about discharge care plans. Journal Of Hospital Medicine: An Official Publication Of The Society Of Hospital Medicine, 7(6), 504-507.

Studer, Q., Robinson, B.C., & Cook, K. (2010). The HCAHPS handbook. Gulf Breeze, FL: Fire Starter Publishing.

Townsley, E. (2012). HCAHPS and patient satisfaction: a case management perspective. Case In Point, 10(10), 12-13.

What are some topics we might educate our patients about?
Medications
Treatment/Procedures
make sure doctors are communicating
Nursing care/ actions
Other possibilities: call light, fall risk, diet
Discharge

HCAHPS and Hospital budget/reimbursement
Reimbursement based on the "always"
1 in 5 people experience an adverse event post discharge
Approximately 20% of hospitalization costs are from re-admissions in 30 days or less: $15 billion
$12 billion in readmission costs are preventable
(Pennsylvania Patient Safety Authority, 2010) and (Studer, Robinson, & Cook, 2010).
Important considerations with patient education
Patient: age, abilities
Multiple learning modalities
Include family members
Simplicity
Goals
Listen
(Murdock & Griffin, 2013) and(Studer, Robinson, & Cook, 2010).


Theorist relevant to patient education:
Dorothea Orem: Self-care Theory
self-care
actions by individuals to preserve and promote health and well-being
nurses provide service when patient's ability of self-care is exceeded
return patient to self-care
(Allender, Rector, & Warner, 2014)
Patience Doctor
doctpj01@students.ifpw.edu

Autumn Ketrow
deetar01@students.ipfw.edu

Jeannine Mellish
mellje01@students.ipfw.edu

NDNQI
National Database of Nursing Quality Indicators
"our mission is to aid the registered nurse in patient safety and quality improvement efforts by providing national comparative data to participating hospitals and conducting research on the relationship of nursing care and patient outcomes." (ANA, 2013, para. 1)


Know your resources
Printed material already available in unit
Computer databases with printable material
Patient education portal

www.hcahpsonline.org
Full transcript