Many hospital administrators believe that scripting is useful in formulating great patient encounters and influencing Press Ganey scores in a positive manner. However, scripting insults the intelligence levels of the staff members who must recite the canned phrases and the patients who are forced to repeatedly listen to the same scripted lines.
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Nurses who have the misfortune of working at healthcare facilities that utilize Press Ganey patient satisfaction surveys are probably subjected to the practice of scripting.
For those who are unfamiliar with scripting, here's a brief rundown. Every nurse is supposed to recite the same pre-written scripted phrases to all of their patients with every interaction. The point is to reinforce the phrase 'very good care' in every patient's consciousness so that, upon each discharge, the facility will generate favorable patient satisfaction survey results. 'Very good care' translates into a score of five on the Press Ganey patient satisfaction survey.
A score of five is the highest rating each patient can bestow upon the facility on this particular survey. Likewise, 'very poor care' is the lowest rating any patient can give and would translate into a score of one on the survey.
Here are a few striking examples of the canned, scripted phrases some members of nursing staff are expected to recite to their patients. Be sure to take notice of the prominence of the key words 'very good':
"Is there anything I can do to make you more comfortable? I have the time!"
"We know you have many choices, so I'd like to thank you for choosing ABC Hospital, which is a very good facility."
"Your doctor is very good!"
"My goal is to exceed expectations and provide very good care!"
"Thank you for choosing ABC Hospital and I wish you well!"
"I want to assure you that we will do everything possible to exceed your expectations."
"Our goal is to provide you with very good care!"
"In 7 to 10 days, you will receive a survey from the hospital regarding your stay."
"Please let me know the moment we can do something better!"
"Staff recognizes this must be an inconvenience for you, but we strive to provide very good care!"
"You are making very good progress!"
"I am pulling the curtain to ensure your privacy."
"Our team wants to make your stay very good!"
"What? You asked for graham crackers 15 minutes ago and haven't received them? I'm sorry! That is far short of the very good service we aim to provide!"
"I sure want to ease your pain! I am going to get your pain medication!"
When dealing with scripting, I call shenanigans. I do not use scripting because the canned phrases sound phony and insult the intelligence of the patients. Moreover, repeated use of scripting insults the intelligence of nursing staff because management no longer believes in our human ability to establish connections with patients and families. Does administration truly believe that patients will automatically return surveys with ratings of 'very good care' if staff continually repeats the phrase?
I am wearily cognizant of all the new pressures surrounding the linking of Medicare reimbursement rates to scores received on patient satisfaction surveys, but uttering canned scripts over and over seems robotic and is devoid of any critical thought. Our encounters with patients should be honest and warm, not derived from phony scripts where the primary goal is reinforcement of a particular phrase.
