Increasing Press Gainey Scores

Nurses General Nursing

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For those practicing in an acute care hospital, besides AIDET, hourly rounding, etc. What EBP nursing interventions do you guys do in your hospital that increases HCAHP scores?

Oh yeah, I forgot to let everyone know: I'm not an administrator. And yes, I totally agree with happy nurses = happy patients. We do fight for higher pay and better employment benefits, better staffing ratio (oh yeah, 4:1 or 3:1 telemetry ratio is no bueno for us, we want better!), hiring experienced staff, all the rainbows.

Our patient demographics are mostly the unfortunate souls, low income, no insurance, I-pay-taxes-so-you-work-for-me patients. The I'm-allergic-to-tylenol-motrin-vicodin-and-morphine-but-give-me-norco-and-dilaudid-and-wake-me-up-if-I-happen-to-be-sleeping patients.

I'm just wondering in your practice what works as far as EBP interventions to make patient stay experience better.

See, and that SUCKS, because there is also evidence to show that urban hospitals that serve primarily low income/uninsured/underinsured patients have a much harder time with HCAHPS scores. Large Urban Hospitals at Disadvantage by Current Medicare and Medicaid Patient Satisfaction Rating System - The Mount Sinai Hospital

I have no idea what to tell you. I personally make it a point to fill out every patient satisfaction survey I'm given with links to the studies showing how patient satisfaction is HURTING healthcare and then telling them how wonderful my nurses were because they treated me for the condition I came in for, not because they gave me a sandwich or an extra blanket. It's the only form of protest so far that I've thought of that might make even the slightest dent. Sorry for your situation. :/

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Oh yeah, I forgot to let everyone know: I'm not an administrator. And yes, I totally agree with happy nurses = happy patients. We do fight for higher pay and better employment benefits, better staffing ratio (oh yeah, 4:1 or 3:1 telemetry ratio is no bueno for us, we want better!), hiring experienced staff, all the rainbows.

Our patient demographics are mostly the unfortunate souls, low income, no insurance, I-pay-taxes-so-you-work-for-me patients. The I'm-allergic-to-tylenol-motrin-vicodin-and-morphine-but-give-me-norco-and-dilaudid-and-wake-me-up-if-I-happen-to-be-sleeping patients.

I'm just wondering in your practice what works as far as EBP interventions to make patient stay experience better.

I would love 3:1 or 4:1 lol, we do 5:1 on my tele unit. We serve the same type of patient population.

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Not to be rude but did you just say 1:3 ratio is inadequate for telemetry patients? Even the California union-mandated ratios call for 1:4 or 1:5. No hospital can afford to literally double their nursing staff to give everyone that easy of an assignment. If orientees on my unit can safely take a CRRT patient on multiple pressors along with another vented patient on multiple pressors, insulin drips, etc. then you can handle more than 1:2 for telemetry patients. And I am completely in favor of eliminating nurses eating their young/inter-nurse fighting, promoting safe staffing ratios, etc.

On the subject of Press Gainey and other surveys, I could care less. I provide good care to patients, am respectful to family, am always willing to explain things/provide education, so on. If a patient has unreasonable requests I will inform them how and why their request is unreasonable in a calm manner If they somehow still give me a bad survey I don't even give it a first thought, let alone a second. If management wants to slap me on the wrist I could care less. I've worked the floor, ED, trauma ICU, and have seen tons of hissy fits to me and my colleagues. Never have I seen an actual nurse punished for it.

Management can worry about their Press Gainey scores, I don't care.

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Specializes in Psych, Peds, Education, Infection Control.

I've always been really amused/frustrated (depends on my mood) by the fact that, per facility policy, we have to give my patients (and not their families, the patients themselves) the surveys at discharge - as it's peds/adolescent psych. The small kids, we have to explain most of the questions to. Most of the adolescents did NOT want to be here and vent their anger in the surveys. Actual written response to "What could we have done better?" - "NOT ADMIT ME." And that was one of the tame ones. We do get some reasonable teens who answer...well, reasonably. Occasionally we have some A+ patients who really did need help and recognize that. The Child Unit (ages 4-12) gets consistently good scores, probably because the adults are reading/explaining the survey to their patients, where on Adolescent, we can't.

MORE STAFF, THOUGH, SERIOUSLY. No one wants to hear that solution to the problem (whatever the problem is) but it's usually the best one.

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Besides RN staffing -

Another thing I've wondered is why they don't make effort to gather a serious volunteer force to help with some of their customer service goals. Perhaps volunteer duties don't cover a ton of the items on the surveys, but they could affect someone's overall impression of the experience. They certainly can bring blankets and drinks as appropriate, check in with patients to see if there are other needs that could be reported to the RN, help entertain child visitors....lots of stuff. And the thing is, when they do those things, RNs just might have a little more time to do what only RNs can do.

Part of the problem as I see it is that RNs have a particular and very serious job to do, and we're expected to do that plus attend to everyone else's whim and fancy.

Their overall messages are so incongruous it's hilarious in that sad kind of way: One minute we're listening to yet another mandatory presentation about how many people we (supposedly) kill every year due to errors, and the next minute it's all about scripting and, well, a whole bunch of junk that is designed to make people "feel" a certain way.

Oh, and this situation - providing nursing care - is not like Disney, Toyota, the airline industry, or other completely inappropriate analogy. Let's stop with that; I think the MBAs have had quite enough to say about all of this.

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Besides RN staffing -

Another thing I've wondered is why they don't make effort to gather a serious volunteer force to help with some of their customer service goals. Perhaps volunteer duties don't cover a ton of the items on the surveys, but they could affect someone's overall impression of the experience. They certainly can bring blankets and drinks as appropriate, check in with patients to see if there are other needs that could be reported to the RN, help entertain child visitors....lots of stuff. And the thing is, when they do those things, RNs just might have a little more time to do what only RNs can do.

Part of the problem as I see it is that RNs have a particular and very serious job to do, and we're expected to do that plus attend to everyone else's whim and fancy.

Their overall messages are so incongruous it's hilarious in that sad kind of way: One minute we're listening to yet another mandatory presentation about how many people we (supposedly) kill every year due to errors, and the next minute it's all about scripting and, well, a whole bunch of junk that is designed to make people "feel" a certain way.

Oh, and this situation - providing nursing care - is not like Disney, Toyota, the airline industry, or other completely inappropriate analogy. Let's stop with that; I think the MBAs have had quite enough to say about all of this.

Yes, yes, yes. Here's a dumb question: do candy stripers (or some version of them, you know, high school aged volunteers) even exist any more? I know I don't see them in my hospital except maybe a handful of them. The used to be around in much greater numbers, and that was what they did: bring newspapers and ice water and coffee and blankets and pillows and stuff like that. They were also volunteers, if I recall correctly. What ever happened to that? Did administrators do away with it for (I assume) budgetary and liability reasons? Or is it still around in some places and just not at my facility?

Also, yes, nurses are expected to be all, do all, see all, and have wheels on our feet and be able to sprout an extra arm out of our bodies at will. I can do that....if I have ONE patient. MAYBE if I have 2. 3? Forget it. (I work L&D, so it's different in my area) I work with an awesome team of techs, nurses, environmental staff (they make a HUGE difference), and docs, and THAT is why we have great scores. Because we all pull together, and everything gets done, and gets done well. Because there are ENOUGH of us to do the job. My hospital isn't new or glamorous or anything special. It's the people there who make it special. Corny but 100% true.

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Yes, yes, yes. Here's a dumb question: do candy stripers (or some version of them, you know, high school aged volunteers) even exist any more? I know I don't see them in my hospital except maybe a handful of them. The used to be around in much greater numbers, and that was what they did: bring newspapers and ice water and coffee and blankets and pillows and stuff like that. They were also volunteers, if I recall correctly. What ever happened to that? Did administrators do away with it for (I assume) budgetary and liability reasons? Or is it still around in some places and just not at my facility?

Not a dumb question. I wonder too. What I've known of recently are retired volunteers through the hospital guild or foundation, but their volunteering doesn't seem to be much on units or involve the bedside. I don't know for a fact why that is; it's possible it has something to do with concerns about HIPAA, but since HIPAA is so largely misinterpreted (even by people who should know better), I strongly suspect that it doesn't prohibit volunteers from interacting with patients in the way we're talking about. It's probably more that there's a bit of a lack of control over unlicensed people, meaning - what are they going to do if a volunteer commits a major HIPAA breach? They can't get fired and don't have a license to worry about. So they tell them they can't volunteer anymore? That's probably not enough of a disincentive, and the stakes admittedly are high.

On the one hand, a bold solution is needed. They do have to worry about HCAHPS and I don't see that going away any time soon. The volunteer conversation shouldn't be written off. On the other hand, if you want to say that volunteers can't be at the bedside, well, there's always stocking - now you have techs that are able to focus on direct patient care instead of direct patient care plus 20 other things including stocking. Volunteers can certainly stand in hallways (on the unit) and smile at people and thank them for coming and give directions and function as basically a host.

Imagine if younger people (reminiscent of candy stripers) were trained in a 'host' sort of position. I think it would be a fantastic way to 'connect' more with the younger, very customer-service aware crowd...and lots of kids either desire or need unpaid/volunteer experience to meet some of their educational goals...

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Specializes in PCCN.

yes, we have high school volunteers. Very thankful to have them. But they really cant do much. run labs, grab waters. they cant toilet patients( or do any pt care ) , and thats the bulk of what needs to be done, and we cant keep up. We need more techs just to toilet all these pts. So our "satisfaction scores" suck, because were not available when pts want us.

and yes, many pts could care less about other pts. My co staff and I were berated by a lady this whole weekend for attending to others, before her.

Guess we'll be getting a crap score on that survey.

Solution, Hire more staff . but noooo. that takes away from the ceo pay.

Ahh bad scores. They are the nurses fault.

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Specializes in Critical Care.

IDGAFTHF what patient satisfaction scores are. They come to the hospital for healthcare, not an oil change.

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Appropriate nurse to patient ratios, adequate support staff/resources/equipment, smooth/clear communication amongst all coworkers, and ample financial reimbursement for nurses. (Because employers know that a happy nurse means happy patients!) Oh! And some sort of Ativan aerosol misting system probably wouldn't hurt, either.

The real-world answers, however, probably include things like increasing the soda and snack selection. Or free television. Sigh.

Actually, proactive hourly rounding (i.e. not just looking-in at the pt but actually checking on/responding to their needs) and answering each-others call bells helped us a bit.

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Giving everyone Dilaudid and Ativan; frequently...

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I concur...

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