ways to improve in-patient satisfaction

  1. At our hospital we send out a survey after discharge to each patient. On the previous results to that survey, it was revealed that two areas were scored horribly among the nursing dept:

    1. in-patient satisfaction
    2. how well the nurses kept you informed
    (they really go together if you think about it, though)

    What I was wondering is if nurses from this site had any suggestions. Do you find that one thing works extremely well for "in-patient satisfaction" at your unit/hospital? have any of you had this problem and how was i addressed?

    A couple of things that we have really taken seriously is a nurse from our unit doing daily rounds to welcome new patients and answer any questions/give the pt. a small hand out about our unit (Med-Surg Unit). Another thing is we have to move pt's around a lot bc we have a lot of semi-private (2-beds) rooms. This is done for multiple reasons: example we find out one has c-diff or we may have to combine two male patients in one room to make a female room. What we do is give the pt/family a gift certificate to our cafeteria for this common inconvenience.

    We found the results of the survey extremely disheartening and are seeking ways to improve bc our institution is growing quite a bit and we really need to keep up w/ keeping the patients and families happy...I am open to any suggestions! Thanks!
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    About evans_c1

    Joined: Jun '05; Posts: 123; Likes: 1

    13 Comments

  3. by   emmybsu
    At our hospital, we do hourly rounding during the day and 2 hour rounding at night. This has increased our pt. satisfaction considerably. We have a set scripting that we try to follow. It introduces ourselves to the pt. and their family, what our title is and what our duties will be. We are also supposed to introduce our support staff and anyone else.

    On our hourly rounding, we ask them the three P's - pain, potty, and position. This decreases falls, call light usage, and increased pt. satisfaction. This was done hospital wide and our numbers have increased from the 70's to the 90's within our national size hospital group.

    Hope this helps a little. Good luck with pt. satisfaction!!
  4. by   sanctuary
    When my Beloved was admitted for a bowel obstruction, every time we changed services and did another RN assessment, they ended with "any questions about what we just talked about? Is there anything I forgot to ask? Is there anything you want right now? Each time it seemed that they were really trying to help. And there was a lot of attention to pain.
  5. by   vamedic4
    Listening to the patient and addressing concerns within an acceptable time frame are the two most important things any hospital can do to improve patient satisfaction.

    Hospitals have a bad habit of not listening to staff, but I guarantee that if you piss the wrong patient off, hospital administration will never hear the end of it....and deservedly so in some cases.
  6. by   catlady
    One of the reasons nurses aren't keeping patients informed is that the nurses aren't being informed. The doctors don't always remember to keep us in the loop, so we're scrambling to find some documentation in the progress notes about the plan of care. But of course, that's the nurses' fault. Everything is, you know.
  7. by   Antikigirl
    I think that those two questions are so broad that they can't be a useful tool in evaulation.

    In patient satisfaction. Okay, they are in a hospital, how much satisfaction is one really going to get? Even with the best of care, lots of TLC a person really doesn't have a 'satisfying' experience because they are ill and not at their best, and heck...the money issues alone would have me marking that down as not very satisfied.

    And the question of nurses informing them, what are you supose to be informing them about all this time? It differs with each pt and the MD's! Is the patient in for observation or rule out? Typically those don't get a lot of info because they are just being observed or tests being performed (which the results of which are told by the MD's not me...I will come back and explain if they need). And patients like to know everything typically...same with their family...so most people would say that no...info was in short supply (Hipaa hurts in this aspect too). The questions are way too broad....

    I would have broken that down to certain aspects of care like, do you feel that you were able or were assisted well in hygeine? Do you feel your room was comfortable? Do you feel that the nursing staff was available for you when you needed? (if not, please explain). Was hospital administration available to answer any questions if needed? Where social services available to you if you needed? Was spiritual help available to you if needed? Do you feel your doctors were there for you and your questions? Do you feel your doctors made sufficient rounds?

    All these can point to specific probelms...and that is much more helpful! People don't know how hospitals run, and that is typically is a 24/7 hurry up and wait game with info and treatments. So I see broader questions as counterproductive.

    Personally, I would give another questionaire out to pin point areas that were not scored high and uncover the probelms for their specifics! I mean, a patient could put down that they felt the RN staff was too overwhelmed or overworked to be there enough...and that would have been a ding against both those broad questions right? Or, one bad experience had them all negative about the entire stay and voted that way. Or a patient wanted more than what could be provided. Or a patient was angry with their MD's and included RN's in that catagory, or a patient hated the food, or was angry they couldn't shower, or upset their family couldn't get all the information about them, or a patient was so painful or drugged up they didn't percieve things realistically...all these could decrease both questions scores!

    Focus now on the specifics of care...and that will really help get things going in the right direction!
  8. by   evans_c1
    Quote from TriageRN_34
    I think that those two questions are so broad that they can't be a useful tool in evaulation.

    In patient satisfaction. Okay, they are in a hospital, how much satisfaction is one really going to get? Even with the best of care, lots of TLC a person really doesn't have a 'satisfying' experience because they are ill and not at their best, and heck...the money issues alone would have me marking that down as not very satisfied.

    And the question of nurses informing them, what are you supose to be informing them about all this time? It differs with each pt and the MD's! Is the patient in for observation or rule out? Typically those don't get a lot of info because they are just being observed or tests being performed (which the results of which are told by the MD's not me...I will come back and explain if they need). And patients like to know everything typically...same with their family...so most people would say that no...info was in short supply (Hipaa hurts in this aspect too). The questions are way too broad....

    I would have broken that down to certain aspects of care like, do you feel that you were able or were assisted well in hygeine? Do you feel your room was comfortable? Do you feel that the nursing staff was available for you when you needed? (if not, please explain). Was hospital administration available to answer any questions if needed? Where social services available to you if you needed? Was spiritual help available to you if needed? Do you feel your doctors were there for you and your questions? Do you feel your doctors made sufficient rounds?

    All these can point to specific probelms...and that is much more helpful! People don't know how hospitals run, and that is typically is a 24/7 hurry up and wait game with info and treatments. So I see broader questions as counterproductive.

    Personally, I would give another questionaire out to pin point areas that were not scored high and uncover the probelms for their specifics! I mean, a patient could put down that they felt the RN staff was too overwhelmed or overworked to be there enough...and that would have been a ding against both those broad questions right? Or, one bad experience had them all negative about the entire stay and voted that way. Or a patient wanted more than what could be provided. Or a patient was angry with their MD's and included RN's in that catagory, or a patient hated the food, or was angry they couldn't shower, or upset their family couldn't get all the information about them, or a patient was so painful or drugged up they didn't percieve things realistically...all these could decrease both questions scores!

    Focus now on the specifics of care...and that will really help get things going in the right direction!
    Well, we don't make the questionare. They are not even sent from our facility in fact. They are sent from an institution on the west coast I believe. It does break it down further..but I was just seeking some basic info on the issue. It seems people are usually unhappy with everything so why not just address every issue?
  9. by   traumamomtx
    We have the exact same thing at our hospital. We are always low on our satisfaction results mainly: pain management and patients feeling like we care. I think if the management was a little more supportive of the staff and also looked at the types of pts we care for and many of their situations their attitude would change. We are a trauma floor so we get: GSW, Stabs, MVC, Suicide, and lots of drug dependent people. It is very demanding if not sometimes impossible to completely please these pts. Not only are they going through physical issues they definitely are taking on mental ones with their situation and usually families. I don't think any of these issues are considered when these surveys are reviewed. All it really does is bring down the staff moral on our floor.
  10. by   catlady
    Quote from evans_c1
    Well, we don't make the questionare. They are not even sent from our facility in fact. They are sent from an institution on the west coast I believe. It does break it down further..but I was just seeking some basic info on the issue. It seems people are usually unhappy with everything so why not just address every issue?
    Because, despite my sarcasm in my previous response, not every issue is a nursing issue. I am sick and tired of being blamed for bad food, bad housekeeping, poor ventilation, missing doctors, etc., etc., etc. TriageRN was right on when she broke down the questions into specifics.

    If you have a crummy questionnaire, then fix the questionnaire. Quit allowing nursing to take the weight of the world on its shoulders because everyone else is too lazy to accept their share of responsibilities.
  11. by   evans_c1
    "On our hourly rounding, we ask them the three P's - pain, potty, and position."

    the three P's...that is awesome! Would it be okay if I suggested that to my management? I don't want to use it if you have a copyright or something, haha! That is so clever!
    So you have found hourly rounding to be a great success on your unit?
    Last edit by evans_c1 on Sep 6, '06
  12. by   veegeern
    Quote from catlady
    Because, despite my sarcasm in my previous response, not every issue is a nursing issue. I am sick and tired of being blamed for bad food, bad housekeeping, poor ventilation, missing doctors, etc., etc., etc. TriageRN was right on when she broke down the questions into specifics.

    If you have a crummy questionnaire, then fix the questionnaire. Quit allowing nursing to take the weight of the world on its shoulders because everyone else is too lazy to accept their share of responsibilities.
    :yeahthat:
  13. by   LeahJet
    You know, once upon a time....not long ago really..... giving excellent care was satisfying to the patient and their family.

    I am in agreement with the others that have said that a lot is grouped under "nursing", unjustly. Is it nursing's fault that the TV only has 13 channels or that your salsbury steak was a little dry?
  14. by   dcmonagh
    Greetings

    I hope I'm not being presumtuous in posting- I'm not starting my PN classes until the Spring semester. My Mother is being discharged tomorrow after being in the hospital for a lower GI bleed. I can share some of what she and the family thought about the nursing care we recieved.

    The night she was first admitted, it took several hours from ER to the room and to get the mediciation to stop bleeding started. Around midnight she had two very bad bleeds. My sister was in the hospital with her. That was probably a poor choice as she doesn't deal well with blood. After a paniced call from her, I arrived to find her in near hysterics and my mother pale and having tremors. She was convinced she was bleeding to death. There was no staff in the room. It seemed to me that she was a little in shock. (I'm sure there's a clinical definition of shock and I"m also sure that I don't know it yet )

    I don't know what they were told, but they were convinced that no one had called a doctor and that no one was doing anything to help her. They called Physicans who were personal friends at 2:00am on the Dr's cell phones to get a doctor there. I'm sure that occurred because the nursing staff wasn't telling Mom or my sister what was going on and what they were doing.

    I was unhappy with the nursing staff because there was no one there taking control of the situation. I'm sure there were things they needed to do to make sure she was taken care of. I do feel that SOMEONE professional should have been in there with them. I held Mom's hand, got her calmed down, calmed my sister down. The DR arrived wrote orders for her to go to ICU and for a blood transfusion. No one told us how long it would take to get her transferred, no one told us what the process would be to get blood, no one told us ( And I mean my mom or any family member) what was going on. I had to go to the nurses station and ask periodically to get any information.

    It wasn't until she was placed in ICU and we talked with the ICU RN that we got information about whether she was stable and what the process for her treatment would be.Things went well from there. She was discharged a couple of days later.

    2 days after discharge she was admitted again and placed on the Telemetry floor. That nurse kept us informed about what was going on. When the doctor needed to be called and was difficult to reach, he let us know. He let us know what he was doing every step of the way. I think he was absolutely fantastic. I do not feel that way about the nurse we had at the first admit.

    Nurses and Doctors see Bleeds and things like that all the time I'm sure. Patients and their families don't. It's very scary to the patient and to the families. The more we know the better we are able to cope and help. Just a little time taken explaining can do wonders as to how a patient and their family are going to rate you.

    Please remember this is just my opinion and your mileage may vary.

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