Ask These Three Questions During Rounds to Improve Patient Experience

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"When I round on my patients, they tell me great things about their nurses and say how happy they are with their care, but the surveys tell a different story. Why?"

This is a frustration many leaders experience: patient survey results that do not align with what patients say during rounds.

The problem lies in the questions we ask during rounding and the information these questions gather. Many leaders ask patients if they are satisfied with their care; however, this question measures happiness rather than the care provided and thus doesn't give an accurate gauge of the patient experience.

Instead, ask these three questions to identify the gaps in patient care that affect survey results. Responses to these questions will provide actionable data that can be used to create simple reports that reveal what your patients are experiencing and what you can do to improve their care.

1. "Why do you use your call light?"

When there is high call light usage, it often means the care team is not proactively meeting patients' needs. This can negatively impact HCAHPS scores for responsiveness, pain and communication, and subsequently, overall ratings.

Develop a checklist with typical patient responses and mark why each patient used their call light during rounds. This will equip you with the data you need to identify trends and coach your team in any problem areas. For example, if patients are consistently using their call buttons for pain medicine, you know to focus on strategies that specifically address pain management.

2. "Is the patient's board updated?"

The patient's communication board is the link that ensures the entire care team is on the same page about a patient's plan of care. It also serves as a visual reminder for the patient about what to expect. If the plan of care is missing on a patient's board, it can contribute to low results in the care transitions composite. And for patients admitted to the hospital from the emergency department, an incomplete ED communication board can cause lower HCAHPS survey scores in the nurse communication composite.

When you round, audit each patient's board to make sure it is updated, complete and written in terms the patient can understand. Keep note of any missing or incomplete elements and create an organization-wide standard for care boards to build consistent cross-departmental communication.

3. "Can you describe the education you received before coming in for surgery?"

In the ambulatory setting, patient education can affect several domains on the OAS CAHPS survey, including communications about the procedure and recovery.

If only a low percentage of patients can recall the instructions given to them, you must work with your team to more effectively communicate with them. Using keywords, clear language and the teach-back method will help ensure patients understand all aspects of the surgery, from pre-procedure to recovery.

Each of these questions will provide you with meaningful data to help you get to the bottom of low survey results. Once you understand what your patients are really saying, you can give them the exceptional care they deserve.

By Erin Shipley, RN, MSN, healthcare coach at Studer Group