Tying Patient Satisfaction to Medicare Reimbursement is Problematic - page 2

by TheCommuter 19,222 Views | 62 Comments Senior Moderator

Patient satisfaction surveys have been receiving an amplified amount of attention at hospitals and other types of healthcare facilities, especially since the results of these reviews now have a significant effect on Medicare... Read More


  1. 13
    This pretty much articulates every objection I have to these stupid patient satisfaction surveys in a clear, concise nutshell.

    Essentially I won't get a raise for providing quick, competent, lifesaving care to a critical patient, but if I facilitate the delivery of snacks and dilaudid to every patient that asks for it I get better ratings and a raise.

    Priorities? Standards? What are those?
    Sammie7, Friskee, Jessy_RN, and 10 others like this.
  2. 0
    I have a question about this...If you receive a questionnaire and don't submit it, does that affect anything? Is 'No comment' seen as 'bad comment'?
  3. 5
    Quote from Jeweles26
    I have a question about this...If you receive a questionnaire and don't submit it, does that affect anything? Is 'No comment' seen as 'bad comment'?
    I think it only counts if a patient submits a survey.

    And I agree, KnitWitch. Forget my professional nursing judgement. Give the somnolent patient their dilaudid, klonopin and benadryl all at the same time because "it's good for satisfaction scores." Let the patient go downstairs and smoke even though we're a non-smoking facility. You're on a 1500cc fluid restriction but it's okay to have all those soda cans and juices at your bedside because it makes you happy. You're diabetic? Go ahead and eat all of those sugar-laden snacks at your bedside, it won't mess with your blood sugar!
    roasted, Sammie7, Jessy_RN, and 2 others like this.
  4. 9
    An unsubmitted form can't be counted as anything else, I would presume. It is just logged as not received, but not counted as negative.

    I concur with that article. The survey should be for internal use only, by someone qualified to know the trivial from the important, and should NOT be an employee or hospital evaluation tool. The lunacy of having pay and performance ratings based on evaluations by probably the very people LEAST-qualified to rate it is one of the key things that infuriated me and really soured me on finishing nursing school. It's outrageous that those probably the least qualified to evaluate my competence as a nurse have so much power to affect my career. It truly baffled me why nursing as a profession is treated the way it is. Your work is essential to good patient outcomes, and a hospital really can't run effectively without nurses. Yet, nurses are treated almost like servants, by everyone. It's nuts. I don't want that job anymore. I was already burned out on the bull_t and waitressing after just one year of diploma school. At least diploma school threw us right out there in the nitty-gritty so that the savvy adults who already have the skills to evaluate an employer and a workplace could see what the big picture really is.
    ceccia, Sammie7, applewhitern, and 6 others like this.
  5. 6
    I too think it is a ploy to decrease reimbursement. I am interested in knowing how this will affect staffing ratios. If administrators see a correlation between staffing ratios and patient satisfaction, then maybe adequate staffing will become priority. Let’s see…losing money because of poor patient satisfaction or decreasing the bottom line to add staff to make patients happy. Hmmmm. Let’s be honest, hospitals are becoming Hilton Resorts. While I think it is nice to have a comfortable ambience, it sets expectations higher than what I feel can be delivered unless staffing changes are made.

    What do you suppose will happen to the smaller hospitals that do not have the capital to renovate or pay fair salaries?
    Friskee, Jessy_RN, Ir15hd4nc3r_RN, and 3 others like this.
  6. 3
    Quote from ParkerBeanCurdRN,BSN
    What do you suppose will happen to the smaller hospitals that do not have the capital to renovate or pay fair salaries?
    I think a handful of the small hospitals that lack deep pockets/capital will fold up, go under, and close their doors for good as the result of continual monetary losses.
    Jessy_RN, Sugarcoma, and NJnewRN like this.
  7. 11
    I think the ship has sailed for me. Now, I am over the shock and dismay and would just like to move on. Does anyone have high scores? Any suggestions on how to answer call lights as soon as the patients would like?
    Any suggestions on how to keep a 24 hour facility quiet at night?
    Any suggestions on how to keep a 24 hour facility with frequent traffic in and out clean?
    Any suggestions on how to teach side effects to people who don't care about them?
    I would do anything to have others think my co workers and I do a good job. I know we do.
    Sammie7, batmik, Friskee, and 8 others like this.
  8. 14
    I began my very first job as a 16 year old high school student. Worked continuously through high school and nursing school. I worked as a RN for approx 5 years, most of that in hospitals. I was home with my kids for years, then went back to the hospital per diem for another year and a half. In all of my years working, from back when I was 16, I never, ever received a "write up". Never had a bad evaluation at work. I consider myself to be a very hard worker.

    What made me finally leave my per diem job (and acute care) for good? Last year, I received my first ever write up. The reason: A patient's family told my nurse manager that they felt I "wasn't in the room enough". I got a phone call from my manager, telling me about the family's complaints. Apparently, they were also angry that I wouldn't give the patient a tylenol. 1) He had no orders for tylenol, and I had documented that I tried repeatedly to contact the doctor. 2) The patient was extremely ill and in liver failure!! My nurse manager actually told me that it wouldn't have been a big deal to "slip him a tylenol" to keep them happy. I could not believe what I was hearing! Customer satisfaction at its finest!

    I remembered this shift, patient and family clearly. The patient was a DNR, and had many, many issues. The family was furious at the hospital and the doctors over his care. They were not happy campers in general. I knew I was in for it, because I was the only one that was actually right there, in front of their faces. Sure enough, I was right: My first ever write up at work.

    PS: That shift was a nightmare: It was a weekend and I was working with one other nurse on a "satellite" step-down unit. No supplies, no CNA. Lots of very, very sick patients. I let the on-call nursing supervisor know that the situation was completely unmanageable (repeatedly). Unfortunately, I never filled out the form, protesting the unsafe assignment. I really should have, and I still kick myself. But, like a fool, I didn't want to waste time finding it and filling it out. There was just too much to do... *sigh* I still miss bedside nursing, but I will never go back. It's not worth my sanity.
    jjfromkc, Sammie7, Friskee, and 11 others like this.
  9. 12
    I've been a nurse 3 years this month. Getting away from the bedside soon as I can. We have been sent to "charm school" type classes to learn how to communicate and impress our patients with everything but good nursing care, all for the sake of reimbursement. My skills and knowledge make no difference at my job as long as I make the patient feel as if she has been residing at the Ritz with me as her concierge. Not what I went to school for at all.
    anon456, Sammie7, Friskee, and 9 others like this.
  10. 10
    I do believe that the posters who have said they think it's to cut reimbursement rates are right. Obviously people aren't happy when they're in the hospital. Reimbursement should be paid on medical outcomes, not "my TV wouldn't get the sports channel and I waited ten minutes for a soda"
    ceccia, Sammie7, Friskee, and 7 others like this.


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