Hello all,

I recently took a position in which a majority of the responsibility are patient outcomes. Meeting HCAHPS , SCIP , etc. Im hoping that someone can shed some light with patient satisfaction survey scores. My hospital uses PRC as our surveyor. Recently I had the experience to listen to the recorded survey phone calls which we were scored an "Always and a 9 or 10 on every phone survey call. So, to my amazement when we received our survey scores they were less than stellar. My manager was just as surprised by the report as was I. During a conversation with my manager, I inquired what our Nursing Director's position on the results. The response was that our Director stated the numbers dont lie. Can someone please shed some light how this could be? I am just short of calling PRC and asking to be educated to the process and would if it wouldnt put me in a bad light with management. With this new position's primary goal is to meet protocols and improve and maintain satisfaction scores, I feel that I really need to know what I am up against. We of course have a quality team within our system, however, this position is entirely new and unit based. I definitely need to insure my position is warranted.

All input will be greatly appreciated!

Join the club. Has ANY hospital received top scores on this. Just think hotel. These are the same type of questions asked during hotel surveys. Ridiculous if you ask me. You cannot run a hospital like a hotel.

Why would calling your survey company to ask how the surveys are conducted and scored put you in a bad light with management? Sounds reasonable to me, given your position.

This is nothing against you, but I have to laugh about a whole QI team, now supplemented by a brand new admin position.

go to www.medicare.gov. You can log in a zip code and then compare how various facilities were graded on each question. Unfortunately, the only scored response is "always", which is nearly impossible. The test would not pass my grad schools rules on reliability

Def call PRC. I believe their response will send you packing! Send you stright over to NNU to fight those bastards. The whole thing is rigged! Always never happens in healthcare. What a joke! Although I think we employees should use PRC to evaluate nursing adminstration! Hahaha is your nurse manager always there? Nope. Can you approach your DON? Lol never. Do you trust nursing adminstration? Always or never. Haha never! When applied to nursing admins pretty sure they will fail. Miserably. But hey! Its the name of the game. If PRC scores are the standard to which nurses are held. Same should go for nursing admins.

In my view patient satisfaction scores are the pervue of marketing rather than nursing.

Pt satisfaction scores reflect more than just nursing. Don't they also involve many other departments?? Such as housekeeping, dietary so how can those scores accurately reflect nursing?? Unless you isolate the scores that involve just nursing this is not really a true reflection. If we have pts that are not satisfied with the food that is served, believe me, that can impact their whole stay in a negative way!!! When my mother was hospitalized she had chicken for so many meals she wondered if she was going to sprout feathers!!! There is rarely, if ever, going to be an "always" rating on every question, the survey is programed for failure. Sounds like the whole survey tool needs to be revamped to reflect what is needed for a positive hospital stay. Maybe PRC's game is to get a customized designed survey from the facility!!?

Let me guess, your nurses aren't good enough waitresses/waiters, and when the pts say jump they don't ask how high?

I'm just a bedside nurse and don't actually have anything to do with this stuff, but my unit has an old-fashioned paper survey that is mailed to pts. It has--get this--questions that are focused on our clinical competence, not on how luxurious the county Hilton was. And not only questions about nursing staff, but about the physicians, medical residents, everybody that cared for the patient on the unit. I don't have a copy otherwise I'd give some examples of questions, but I remember reading the survey and thinking "This survey is not completely stupid!"

It is actually possible to have "high" raw scores but rank low in the comparative percentiles - which is the way that Pt Sat is usually reported.

See if you can get someone to do a more sophisticated statistical analysis - multiple regression if possible - to help you figure out exactly which survey items are the most important in terms of the total result. Then you can prioritize your efforts.

It depends on your numbers. If only 10% of patients decide to participate, and out of that 10% even 2% of them are less than thrilled with even one aspect of care, then you are looking at some poor scores.

Even further, the only ones that seemingly like to fill out the survey or take the phone calls are the ones who have some sort of axe to grind. So if you're at 10% response rate, it can happen that 100% of them are less than thrilled. Which REALLY lowers scoring.

Some of the questions are something that you can't fix. "Quiet atmosphere" vs. "Were you nice to visitors"--well, the moment you develop strict visiting hours or quiet times, is when the visitors come....that type of thing. Or delays...is we had a crystal ball to tell someone to the moment how long they would have to wait, we could take appointments in the ER and call it a day.

And the scripting stuff assumes that patients are idiots. As is "talking up" (managing up) the next shift....

In my opinion, the time to take customer satisfaction into account is not when someone is ill. Patients feel as if they have no control, they are vulnerable...and lets face it, cranky (as we all can be when we are ill). If patients have complaints regarding the care they are receiving, there are other avenues to complain about that.

But unfortunately, even if the nursing care was amazing, the fact that you told the patient's cousin to come back during visiting hours, and your whole survey has just flown out the window...

I'm glad to hear other nurses who think the scoring systems are ridiculous. I feel like the recent focus on customer service scores is distracting from quality care. You could be the best nurse who has done a million things behind the scenes for your patient (coordinating their care between different MDs, making sure they are receiving the right meds, catching errors MDs made/things they missed, etc) and at the end of it all, all they remember was the bad food or the uncomfortable bed.

Hospitals are not hotels. Nurses are not waitresses. I am intelligent, I have great critical thinking skills and I have such a huge impact on the course of your hospital stay. I wish patients were led to focus on those things rather than all the fluff. You want a great nights sleep and delicious food, go to the freakin St. Regis. End rant :)