LOW patient satisfaction scores...

magz53 · Feb 23, 2008

Recently had a staff meeting in which the main purpose was to slap our hands over the Press Ganey scores. The countless thank yous, cards, flowers, candy etc. count for nothing and those people must never get the surveys which are random I guess. Some patients come in with a sense of entitlement, are basically miserable people and could never be pleased. Nine times out of ten, they can be spotted and nothing anyone does can avert complaints. They tend to be disrespectful and demanding. Then they are given the opportunity to strike out on these surveys and stir up trouble. Seldom are the complaints valid or a true comment on the nursing care they actually received. So demoralizing for nurses to have such weight put on these Press Ganey reports and soooooo much emphasis on the negative comments instead of recognizing the majority of our patients who are appreciative, have a choice in where they receive care and choose to return to us as they had a pleasant experience. Can not WAIT to retire.

TRAMA1RN · Feb 24, 2008

Press Ganey is to scurge of all medicine! As customer satisfaction becomes more emphasized and patients realize this they ARE going to omplaine more loudly. When I am told thank you by a patient or a family has expressed gratitude I explain to them the importance of putting it in writing, but lets face it, writing a thank you is not as important as putting a compliant in writing is. When you go out to eat or buy a new appliance and are satisfied you probably do not think to write a letter of thanks, but let your service be bad and you WILL go out of your way to let someone know. Good comments are never looked at the way they should be, one thank you should cancel out 10 negatives, but this is never the case because in any service market good sevice is the expected and thereby should not be a surprise when it does occur, and therefore does NOT count. Even with all the understaffing and overuse and lack of supplies and abuse that all in healthcare workers tolerate, good service DOES NOT COUNT, only the negatives count and get figured into the equation. I have worked in all kinds of ER venues from small to level 1 centers and it is the same everywhere.

CEG · Feb 24, 2008

I think that people who have a truly awful experience (or perceive that they did) are more likely to fill out the survey. There is probably a smattering of really happy people, a good amount of middle of the road responses, and a lot of negative. Just a guess- although I think read a study or something about this. I also think people tend to relate their experience to their provider- so a great experience is probably more likely to be attributed to the provider they have gotten to know that the nurse they just met. Versus a negative experience which they are probably more likely to blame on that nurse.

Just as a sidenote- when my first child was born I wrote some pretty negative comments on the survey I received. I had my second child there and stayed in the same room and those things were fixed-- so I was pretty impressed by that. Didn't recieve a survey the second time around, though :)

DutchgirlRN, ASN, RN · Feb 24, 2008

My manager always ask why we think this is the case and it seems that no one has a response
Thoughts?

The nurses need to speak up when asked! No response = no change. I agree that low staffing obviously is a huge factor. When I worked OB we were always adequately staffed and our scores were outstanding and from what I hear their scores are still awesome. I've never heard anyone complain about our OB nurses. The doctors, yes. The nurses, no.

Elvish, BSN, DNP, RN, NP · Feb 24, 2008

I feel your pain. Seems like Murphy's law that the pts who (for whatever reason) had a bad experience are the ones that get the dang pt satisfaction surveys.

Don't get me wrong. I have been a postpartum patient and got one of them myself. The only thing I complained about (not where I work) was someone knocking on my door & coming in my room at 0300 to refill my water pitcher. (I mean really, can that not wait?)

But when a pt complains about us not having snacks, or the water smells funny, or the room being too small, guess what? I hear about it, even though I have absolutely ZERO control over whether said situation can be remedied. I bust my butt to make sure my pts are taken care of, but there are some things I just can't fix. I didn't get a magic wand in the mail with my RN license.

babyktchr, BSN, RN · Feb 25, 2008

Ah, Mr. Press and Mr. Ganey. To meet them in a dark alley...just once.

These surveys are given way too much weight in my opinion when it comes to the reality of care. Patients are filling these things out based on their PERCEPTIONS of their care while in the hospital. Remember, they are sleep deprived, a lot of times taking pain medication and totally overwelmed. The other posters hit the nail right on the head.

We have a person on staff that has the sole responsibility of looking at every press ganey and making sure the bad ones are addressed. In a "press ganey" learning meeting, she sat there and said that there is NO CORRELATION BETWEEN SHORT STAFFING AND LOW PRESS GANEY SCORES. Of course my head spun. I asked her where that literature might be, and if she could get it for me, as I would LOVE to read it. (to this day I have not gotten it). Many hospitals are going to the DISNEY or RITZ CARLTON model for customer service. I only respond....when you go to either, there is a TEAM MEMBER every 5 feet. There is someone to help anyone at any time. Hosptials notoriously understaff and expect 5 star service....

...but I digress. Press Ganeys are just an unfair way to measure satisfaction. At my institution....our RAISE is determined by them.

Batman24 · Feb 25, 2008

Raises determined by patients who could be ticked their sister wasn't given a soda in a timely manner on a busy Med/Surg unit. Or being docked because your patient who was being treated for a stomach condition was told not to eat a Big Mac. And of course the people in ER who are advised not to go out and chain smoke when complaining of an asthma attack. Where has the common sense gone?!

TRAMA1RN · Feb 25, 2008

What I have trouble with is that If I am going to Disney, I am happy and in a different frame of mind than if I am going to the hospital, Apples and Oranges.

PegRNBSN · Feb 26, 2008

As someone who is now very involved in health care as a patient, I can offer some words of advice that will impact your scores.

1. Always always greet your patients with a welcome smile. This includes everyone on your team from secretary to nurse to houskeeper. It makes such a difference. No matter how busy you are you can smile.

2. Never make the excuse to patients that you are busy. When I went in for my port placement, the admitting nurse almost gave me a med I was allergic to and then proceeded to tell me she had admitted so many patients she was having a hard time keeping track of us. This made me very anxious. I will tell my patients, that I am caring for other patients but I leave it at that.

3. Don't have personal conversations or sit around talking where patients can see you.

They don't understand that you are also charting, or doing work on the computer at the same time. Professional behavior where patients can see you is a must.

4. Don't give time frames you cant keep. Don't say I'll be back in 15 minutes when you are going to admit another patient.

5. If someone is a complainer kill them with kindness, for me it works everytime (this one I didn't learn as a patient)

A book I can recommend that gave me alot of insight is If Disney Ran my Hospital.

I agree surveys are frustrating but don't just dismiss them, there is usually a grain of truth behind them. We can all improve.:nuke:

FireStarterRN, BSN, RN · Feb 26, 2008

I think Peg makes some good points, actually. Surveys are annoying, but there are a lot of simple things we can do to improve patient perception, so we shouldn't dismiss them out of hand, even if we don't want Disney to run our hospital.

PegRNBSN · Feb 26, 2008

My son had to read the Disney book for an internship and I started to read it with much skepticism. It is written by a hospital exec (and he might have been a nurse to start his career) who trained with Disney and adapted lessons learned for the hospital setting.

It really was intriguing, especially the part about being a team.

He gives examples of how distructive it is to blame other members of the team ( example the bathroom isn't cleaned and you "blame" the housekeeper.

I highly recommend it.