Well, the "customer" satisfaction survey.....

classicdame, MSN, EdD · Jun 4, 2012

regardless of why someone is hurting we should be able to manage the pain. Might involve tranquilizer, PCA, anxiolytic, or call to MD. I do agree that the patient is not always in a position to judge their care. Since the judgment is really a preception it is our duty to change the perception, even though we may not change the care. For instance, telling them your priority is for them to be comfortable might help with their perception. If we are doing hourly rounds that helps with the "I never saw my nurse" issue.

Anna Flaxis, BSN, RN · Jun 4, 2012

I have an issue with tying reimbursement to patient satisfaction, not because I don't think it's important that patients feel cared about while they're in the hospital, but because patient satisfaction is so subjective, and does not equal good outcomes! Patients can give low scores because of things like slow elevators or having to share a bathroom, that have nothing to do with their actual care.

Of course pain needs to be managed, but that does not necessarily equate to complete elimination of discomfort, which, unfortunately seems to be a common expectation. How often the patient sees their nurse, regardless of whether hourly rounds are practiced or not, is also highly subjective. If you come into the room once an hour, to one person that could be too much contact, while to another, it's not enough.

I think it behooves hospitals to work hard to make patients feel safe, cared for, and treated with respect, but I think it's a mistake to tie reimbursement to it.

**CalicoKitty, BSN, MSN, RN** · Jun 4, 2012

I don't like the satisfaction crap because it relies on people giving something five stars or whatever. I know for myself, when expected to review something, I don't just grant the highest rating if everything was okay/fine. But, now it makes me feel obliged to rate stuff higher, and losing the point of the surveys, imo. There is (almost) always going to be room for improvement.

iluvivt, BSN, RN · Jun 7, 2012

Ironically, I just read an article in a Ca union journal that cited a recent study that the patients with the highest satisfaction scores had a 44 percent higher chance of dying. I left it work so I can't state where the study was published but I remember it was a medical journal. I had to chuckle because all the nurses I know intuitively know this. We know its all about good nursing care and enough RN staff and good support staff. So yes a huge mistake to tie reimbursement with patient satisfaction and that was what the article was trying to prove.

LobotRN, BSN, RN · Jun 7, 2012

I agree with everyone. And I had another thought cross my mind as I've been musing on this. As the population we care for is generally older, I really see a link between staffing levels of CNAs and pt satisfaction in the older patient. We are encouraged on our floor to respond immediately to pt requests or to provide a time frame to the pt forwhen the request can be met, and I agree with this standard because I know pts feel attended to when we can make it happen. BUT! Toileting is the one that gets me going.

To safely mobilize and monitor and post surgical elderly pt to the bathroom takes time, and to do it right you should never leave that pt unattended. This task alone takes on average 15 minutes, and sometimes longer. But when we have 2 nurses for 12 fresh post op pts and 1 CNA, it always seems to strike that we have the crowd that needs to pee 100 cc's every 90 minutes. Or can't pee, but see my other post. Sure, bedside commodes are an option, but then the pt can't pee because sitting next to your bed to pee is weird, and not like being in a bathroo. But I digress.....Anyway....

I think that pt satisfaction surveys should have some sort of cross reference to the staffing levels during that pts stay....That might be an eye opener.

To "iluvivt".....wow. I can see how that happens when nurses feel rushed to meet the things pts perceive as "being cared for" and that overshadows diligent assessment and reassessment (during hourly rounding!) and nursing interventions.

amoLucia · Jun 8, 2012

I have an issue with tying reimbursement to patient satisfaction, not because I don't think it's important that patients feel cared about while they're in the hospital, but because patient satisfaction is so subjective, and does not equal good outcomes! Patients can give low scores because of things like slow elevators or having to share a bathroom, that have nothing to do with their actual care.
Of course pain needs to be managed, but that does not necessarily equate to complete elimination of discomfort, which, unfortunately seems to be a common expectation. How often the patient sees their nurse, regardless of whether hourly rounds are practiced or not, is also highly subjective. If you come into the room once an hour, to one person that could be too much contact, while to another, it's not enough.
I think it behooves hospitals to work hard to make patients feel safe, cared for, and treated with respect, but I think it's a mistake to tie reimbursement to it.

Dear Stargazer - I HAD TO respond to your post. You used my favorite word BEHOOVES! That word just cracks me up! :jester:

To all others posters and OP, I do agree with you all re: tying satisfaction to positive outcomes and esp reimbursement. Sad state of the industry!

sheronep, MSN, RN · Jun 8, 2012

Welcome to my everyday world on the med-surg unit!