As a manager, I take the HCAPS results with a grain of salt. Working in child and adolescent psych, we have to set limits with the kids and give the patient and family a survey at the end. Everyone gets a negative comment posted about them at times, even myself. But if it's a consistent trend I notice from the comments, then I can address it with the staff. I have one nurse who is difficult to work with according to staff, has been for years, and, no surprise, she comes up negatively on the surveys every month as well. So it's "another piece of the puzzle" of performance, in my mind.
You can't fire someone in our organization based on HCAPS; that would be a freaky place to work if we could. I have to have a long history of documentation to fire an employee in most cases.
Overall, our scores are excellent, even though we have kids court ordered to us and have to set firm limits with the kids. Initially they hate the limits but by the end of the stay, they give us good marks because we are setting limits with care and explanation.
I don't hate the HCAPS and I think, in some cases, it can be good for the patient. How often have you been in a hospital when it is extremely noisy at night at the nurses station and can't sleep? Yes, you're in a hospital, you're a patient and it's not supposed to be like home. But you at least want folks to make an effort to be quiet at night, right? Obviously you need to enter the room to perform your job but do you need to hoot and hollar at the nurses station at 3 in the morning? If your scores are low in that area and it is disseminated to the staff to try and be a little quieter at night, then the patient benefits by getting a bit better quality of sleep (when you are not coming in to keep them alive and such).
With all the healthcare changes, and moving to "pay for performance," there is a lot of $ at stake. As much as we don't want to acknowledge it, healthcare is a business as well as a service. I think it can be used as a tool to improve patient care. I do not think it should be worshipped as a golden calf, which it sounds like, in many places, it is.
Sorry to hear it is driving everyone a little nutty. Even as a manager, it is taxing for us as we are held accountable by upper management. I'm sorry your managers are calling you out on stuff that is wrong or plain silly. They should look at the trends and not try and correct one staff whose patient or family is just unreasonable. That is wrong and I'm sorry they are doing that to you.