Tying Patient Satisfaction to Medicare Reimbursement is Problematic - page 2

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... Read More

  1. Visit  TC3200 profile page
    10
    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.
    DizzyLizzyNurse, ceccia, Sammie7, and 7 others like this.
  2. Get the hottest topics every week!

    Subscribe to our free Nursing Insights newsletter.

  3. Visit  ParkerBC,MSN,RN profile page
    8
    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?
    toomuchbaloney, NicuGal, Friskee, and 5 others like this.
  4. Visit  TheCommuter profile page
    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.
  5. Visit  caringfornurses profile page
    12
    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.
    jrbl77, Sammie7, RNKPCE, and 9 others like this.
  6. Visit  Tina, RN profile page
    18
    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.
  7. Visit  serenity1 profile page
    14
    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.
    Stalirris, Godivaa, anon456, and 11 others like this.
  8. Visit  StNeotser profile page
    11
    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"
    bb007rn, ceccia, Sammie7, and 8 others like this.
  9. Visit  1Dreamer profile page
    7
    I have been saying the same thing for a few years now. I too have witnessed numerous times where the nurse who provides the most competent care but does not coddle the patient gets the most complaints. I have seen patient's and their families praise nurses and doctors who give inferior care just because they smile and give repeated scripted responses. Eventually insurance companies will implement this protocol so they too may cut payments. This in turn is going to drive up healthcare cost.
    StNeotser, canoehead, RNKPCE, and 4 others like this.
  10. Visit  jrwest profile page
    6
    Quote from ParkerBeanCurdRN,BSN
    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?
    They won't change the staffing- they will just can the "low performers" and get new ones, since nurses are a dime a dozen....
    toomuchbaloney, Sammie7, Friskee, and 3 others like this.
  11. Visit  jrwest profile page
    0
    Quote from TheCommuter
    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.
    This just happened recently where I live.
  12. Visit  That Guy profile page
    18
    I see this more as a "Oh we know people hate the ER times, hate being sick and are demanding as hell" so therefore how can we save some money...Thats right lets ask them stupid questions and then say you have to score the best on all of them to get paid for it.

    I wish I could pay less when my food takes too long to get to me
    Or the waitress is rude
    Or when the lines are long to get checked out at the grocery store
    or fill in the blank here.
    Stalirris, jrbl77, Sammie7, and 15 others like this.
  13. Visit  turnforthenurseRN profile page
    4
    Quote from Tina, RN
    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!
    This has happened in other areas, too. We were basically told by management that it doesn't matter if a patient is somnolent, if they are due for their pain medicine or Xanax or whatever, you are to give it. Why? Because it's for "patient satisfaction." Screw your professional nursing judgement.
    DizzyLizzyNurse, Sammie7, Jessy_RN, and 1 other like this.
  14. Visit  booncis profile page
    7
    Thank you for the wonderful article and all of the thoughtful comments. All of the above has weighed on me quite heavily already and I'm only in my second of four semesters of school. It seems as though many of us are stuck between a rock and hard place. The hospital is promoting "customer service" as in a hotel atmosphere, professors are promoting "therapeutic communication & safety," third party payers are demanding "safety & efficiency," and patients are demanding everything. It seems as though it all boils down to the almighty dollar. What a sad situation when it comes to dealing with human lives - humans that could our mother, father, brother, sister, etc.

    How can we as nurses be compassionate and effective nurses when we are constantly watching our backs because we're worried about being written up and we're run ragged? How can we be genuine and give of ourselves when we are told to give scripted replies? How can we ensure patient safety when we are short-staffed over over-loaded with patients?

    I have never been a political person, but I feel so strongly about all of this, I am wondering, "How can I make a difference? Who can I talk to? How can I learn more? How can I be involved in the process?"

    I listened to an exasperated nurse explain to my clinical instructor that she was frustrated with patient stay limitations imposed by the XYZ insurance company. When I heard this, I thought "Who at the insurance company is making these decisions? Who are they? How much are they paid? What are their credentials? What's the bottom line of that company? How much do the top dogs make who probably have MBAs and no medical background?" I then said, "I know what I'll do when I graduate! I need to go undercover at XYZ and find out what the heck is going on!!"

    Well, I must get back to the crushing textbook on my lap and turn my thoughts inward to the next hurdle lurking on Tuesday morning.
    PatchycatRN, ceccia, Jessy_RN, and 4 others like this.


Nursing Jobs in every specialty and state. Visit today and Create Job Alerts, Manage Your Resume, and Apply for Jobs.

Top