What is this Press-Ganey business?

[grandmawrinkle]

Never heard of it until I started using this site. I've seen it referred to a bunch of times on here. My facility doesn't use this, so I have no clue. I googled it -- apparently it is some sort of QA/QI company that sends out surveys to patient post-discharge....and what exactly do the hospitals do with this information? From what I've seen on here, it makes nurses lives miserable.

So internal QA/QI departments aren't good enough anymore?

[eriksoln, BSN, RN]

I think a lot of hospitals went to Press-Ganey to gather more uniform information. Internal QA/QI audits were good, but you can't really compare them to Hospital X down the street when they're using PG scores. And since we're all about comparison, especially with everyone trying to get Maaaaagnet these days, it's important to be on the same page.

Get out much? No one is caught up in the "Magnet Status" craze anymore. That fad is out to pasture.............grazing right next to disco music and the mullet.

Admin. finally realized it was not worth it in the long run. People didn't flock to hospitals simply because they had achieved the "Magnet Status" like everyone thought they would. When I quit travel nursing and went back to being staff, I had five interviews with different facilities. ALL FIVE..........when magnet status came up.........the attitude was very "Eh, we looked into it and really don't see it being the right direction for us."

My understanding (by word of mouth) is that the people who granted Magnet Status started thinking they were royalty of some sort. They got out of control, much like the group that decides who gets the Olympics from year to year. They wanted wined and dined and pampered otherwise they wouldn't really give an objective review. Hospitals balked at this and decided to stop trying. Now, no one really cares much about it one way or another. One hospital in my area that was so proud of achieving the status has dropped the label from all its billboards and advertising.

Patients are not the most impartial people in the world.

This is what will eventually lead to the end of PG. How it became so popular is beyond me, its surveys are amateur/generic and the principals it stands on are flawed. Anyone with a basic understanding of statistics would know not to take them too seriously. Biggest flaw being:

This is where the whole idea of letting people with no medical knowledge hold so much power in medical decisions comes into play. Ever read any of the PG surveys? They look and read like they were composed by a college student. They ask questions that point in the direction of good care but miss the mark. Instead of questions like "Were your home medications ordered for you and dispensed in a timely manner?" it wants to know if the pt. felt they were "Included in the formation of the care plan". Pt.'s don't know what that means. So, you have questions that FLY HIGH over the heads of 9 out of 10 pts and the end result is that most of them probably answer it based on an overall experience point of view................"IDK what a plan of care is, but..........that dietary person was nice so I'll put a 4 here." Now, admin. looks at these results and reacts to them. They think "Oh goodey, we got a 4 in involving the pt. in the planning of care." So, they move on figuring their facility has that down pat and focus on other things. This in and of itself is not too much of a problem, not too damaging to the medical process. But, it can be.

It can be especially if you take the same situation but reverse the pt's reaction to the overall experience. Lets say they had said "IDK what a plan of care is, but the housekeeping staff were rude and pushy so I'm going to answer 1." Fast forward to a very angry manager/admin. reacting too it. They see a 1 in the nurses section and now have the impression that pt's feel left out with regards to being a part of planning their care. The EMERGENCY button is pressed firmly. Meetings, many of them, go on for entire days as they all decide how to convince pt's to feel more involved in planning their care. Signs go up in the nurses lounge, nasty remarks about the job market are brought up in staff meetings, educational modules are created by the educational dept. about the subject. Its to no avail though............the scores stay the same. Since the real problem is rude housekeeping and not a pt's feeling like a decision maker............its all wasted effort barking up the wrong tree.

And that issue alone will eventually bring on the end of PG. If the company who did it were smart, they'd find a way to avoid it, but I imagine they are like most other businesses........resting on its laurels collecting as much as they can for what they have, little regard being given to improving the service.

I'll add here too another reason PG fails on so many levels. This is so easy even a caveman can figure it out.

The point of nursing (at least where I do it, on a pulmonary unit in a hospital) is to bring people back to the highest quality of life possible. The ultimate goal...............take them back to where they were before the disease process interrupted their lives. Boy comes in with broken arm.........we fix it, he goes home with cast, comes back and gets cast off. If everything is done right, his arm will be fine, he can return to playing ball and he will never have any complications.

Problem is, with regards to survey's, it is the pt's we are most successful with who are too busy to be bothered with a survey. These people have lives, jobs, family to get back to. Many of them do intend to fill it out and mail it, but very few do. It gets lost in "life", other things come up.

So which pt's are filling out the surveys and mailing them? Not hard to spot them. Its the frequent flyers with little to no life outside of the hospital to return to who indulge in surveys. They have been in and out so much, they are very familiar with the whole process and know the results of a good/bad survey. So, my COPD professional pt. who enjoys their dilaudid and refuses to quit smoking despite having just been in the hospital 3 times this month alone sits at home..........reads the survey and thinks "Gee, if I answer this way/that way..........I bet next time I go in I'll get this and this, it'll be like heaven." How well of a job the nurses and every other member of the care team did is hardly taken into consideration. The survey is filled out to push care one direction or another, a direction that suits them.......not a direction that improves quality of care.

To end, my point is, the pt's we are most able to help are least likely to respond to a survey. If the PG company had anything more than interns and temp. workers working for it, they'd realize the process to get the most objective view is to make filling out the surveys a part of the D/C. There are ways to do it so the answers remain anonymous.

[LPN_mn]

It is not only hospitals using PG. The clinics are using them also and creating alot of problems for the staff. They even use them for staff satisfaction surveys. That is a real joke. The problem is like someone else said they are not worded properly enough to get real honest feedback.

[Mulan]

Get out much? No one is caught up in the "Magnet Status" craze anymore. That fad is out to pasture.............grazing right next to disco music and the mullet.

Too bad no one told that to the hospital in my area that is trying to get magnet status.

They are very much caught up in the "Magnet Status" craze.

[eriksoln, BSN, RN]

Too bad no one told that to the hospital in my area that is trying to get magnet status.

They are very much caught up in the "Magnet Status" craze.

Well, like I said, I had five interviews and each one did a sort of roll of they eyes when magnet status came up. First time it happened I had a "Oh, bitterness........cause you can't achieve it" reaction.

Second time, I had more of a "Ah, it really is hard to get I guess and people are bitter about it." Then after that, as people talked to me about it in different areas, I started to realize................most hospitals are not interested in it anymore. Then came the facility in my area that went out of its way to be a..........IDK what to call it.............."under the radar" member of the elite club (taking mention of the status off its billboards and such) and I can't help but think the craze is over.

I've seen a few other posts on here (not this thread) about how magnet status seems to have lost its........status (no pun intended). It may not be a universal reaction, but thats the reaction I have seen. Just like 80's hair bands have their hanger on fans who still think music peaked in their generation..............I guess magnet status will always a a follower here and there.

[MsbossyRN]

I got one in the mail today from a recent operation I had at a local hospital. I had the urge to fill it out about the nurse text messaging and talking on her cell phone while prepping me for my surgery. The only reason I ripped it up was because I am a recent grad and nursing jobs are hard to come by. So I didn't send it in. I was surprised by the questions because I could answer no to all the quality of care questions they asked. Seriously hospital you know you have horrible service, you don't need a survey to tell you that!

[DanC]

I hate to burst everyone's bubble but the facts are as follows:

1. Press-Ganey is the big boy in the industry.

2. Your facility places great value on the information Press-Ganey gives them.

3. Your facility pays big $$$$$ for this information.

4. Your facility may tell you that they want your input, and they may infact want your inp

5. At the end of the day they will and should listen to Press-Ganey. I say this because if they were giving bad advice they would go out of business. The market will regulate it's own value.

6. If you don't like it quit and go find a job at a facility that does not use Press-Ganey, no one person in any facility from your new never had a job before aid to the CNO or CEO of your facility is necessary to your facility if you truely work for a successful org.

flame on but facts will hold true.

[grandmawrinkle]

no one person in any facility from your new never had a job before aid to the CNO or CEO of your facility is necessary to your facility if you truely work for a successful org.

DanC, I wish I knew what you were saying (I was thinking it would be worth reading, and I did start this thread, after all, so that ~kind of~ obligates me to read the follow-up posts) but I read what you wrote up there THREE TIMES and I can't make heads or tails of it.

[eriksoln, BSN, RN]

I hate to burst everyone's bubble but the facts are as follows:

1. Press-Ganey is the big boy in the industry.

2. Your facility places great value on the information Press-Ganey gives them.

3. Your facility pays big $$$$$ for this information.

4. Your facility may tell you that they want your input, and they may infact want your inp

5. At the end of the day they will and should listen to Press-Ganey. I say this because if they were giving bad advice they would go out of business. The market will regulate it's own value.

6. If you don't like it quit and go find a job at a facility that does not use Press-Ganey, no one person in any facility from your new never had a job before aid to the CNO or CEO of your facility is necessary to your facility if you truely work for a successful org.

flame on but facts will hold true.

Hospital admin. are paying big $$$ for it because they don't know what else to do, not because it has any value. Heck, back in the day people paid big money for 80's hair band tickets..............now those groups CDs are in the dollar bin for months at a time. Same thing.

You say though that the facility should pay for it, giving the impression it has value. Can you back that up? What leads you to this conclusion. Me, I arrived at my poor opinion of it from what I remember from my stats class. I don't think their data collection methods cut it...........how many surveys were not even filled out by the person who was hospitalized I wonder.

[Charis16]

Press-Ganey is "god" at the hospital I work at. Every patient is told they will be sent a survey while in the hospital and then they are sent one after they get out. Our scores compared to the other hospitals around town are posted all through the hallways. They also have decided that "4" which represents "good" on the survey is not acceptable. They want a "5" or "very good" on everything. So now staff must attend or be suspended 3 annual customer service training classes. As a side note the classes with all of the print, media, advertising, etc all came out about the same time our raises were suspended - your average staff member was less than happy. I am all for improvement and doing the best that I can do but I also agree with the previously mentioned - a patient will rate an entire unit or stay on one event or will not understand what he or she is being asked. It is difficult to fully explain the importance of grandma getting out of bed into the chair after abdominal surgery and being extubated. But it will hurt grandma - how dare they - that is all I hear. I have had family's threaten to "call the doctor if you don't do what I say." To which my thought was - go ahead because unlike common assumption nurses don't work for doctors - we work with them. But I had to smile and try to explain for the umptenth time why - while my other pt. starts to brady down into the 40s. I don't mind spending time with families and I don't mind explaining things and trying my utmost best to give the best care I possibly can but understand one thing - you are sick, it is not fun, pain free or an easy ride and you are in the hospital - not a 5 star resort and I am a nurse not your butler.

In the end press-ganey is nothing but a huge thorn in my side which I try with all my being to ignore because I really don't care what a non-medically trained admin (yes I know they "control my job" but the butt kissing nurses that try to please very pt by giving in - well if it hurts to much no you don't have to cough - are bad nurses) thinks of my subQ injection technique or me insisting that mom needs to take deep breaths and cough after surgery even though - yes the horror - it hurts. You want to critique my medical anything - you go get a nursing degree - and we will talk - until then we are talking apples and oranges and I don't thing you are ever going to get your "very good" ratings because no one is ever going to like being in a hospital that much. It is not a happy place for patients - in fact last time I checked most of them were sick in some way, shape or form and that's why they are here.

[Asystole RN]

Press-Ganey is "god" at the hospital I work at. Every patient is told they will be sent a survey while in the hospital and then they are sent one after they get out. Our scores compared to the other hospitals around town are posted all through the hallways. They also have decided that "4" which represents "good" on the survey is not acceptable. They want a "5" or "very good" on everything. So now staff must attend or be suspended 3 annual customer service training classes. As a side note the classes with all of the print, media, advertising, etc all came out about the same time our raises were suspended - your average staff member was less than happy. I am all for improvement and doing the best that I can do but I also agree with the previously mentioned - a patient will rate an entire unit or stay on one event or will not understand what he or she is being asked. It is difficult to fully explain the importance of grandma getting out of bed into the chair after abdominal surgery and being extubated. But it will hurt grandma - how dare they - that is all I hear. I have had family's threaten to "call the doctor if you don't do what I say." To which my thought was - go ahead because unlike common assumption nurses don't work for doctors - we work with them. But I had to smile and try to explain for the umptenth time why - while my other pt. starts to brady down into the 40s. I don't mind spending time with families and I don't mind explaining things and trying my utmost best to give the best care I possibly can but understand one thing - you are sick, it is not fun, pain free or an easy ride and you are in the hospital - not a 5 star resort and I am a nurse not your butler.

In the end press-ganey is nothing but a huge thorn in my side which I try with all my being to ignore because I really don't care what a non-medically trained admin (yes I know they "control my job" but the butt kissing nurses that try to please very pt by giving in - well if it hurts to much no you don't have to cough - are bad nurses) thinks of my subQ injection technique or me insisting that mom needs to take deep breaths and cough after surgery even though - yes the horror - it hurts. You want to critique my medical anything - you go get a nursing degree - and we will talk - until then we are talking apples and oranges and I don't thing you are ever going to get your "very good" ratings because no one is ever going to like being in a hospital that much. It is not a happy place for patients - in fact last time I checked most of them were sick in some way, shape or form and that's why they are here.

You seem very entitled.

Thank God the patients have the blessed luxury of being able to have a moment of your time.

You provide a service, they are purchasing a service. No different than the plumber or roofer or auto mechanic. If you hate dealing in customer service then move to a profession that does no require you to deal with people.

[Asystole RN]

I have no idea why so many of you care why your hospital may or may not use Press-Ganey.

If you don't like it you are not being forced to work there...

Some of you seem very entitled as though the hospital is some how lucky to have you as an employee or some how the patient is lucky to have you as a Nurse.

The physical/medical part of Nursing is only half the profession. If you are a good Nurse you are also providing good customer service. So what if the patient is demanding! Anticipate their needs, teach them, and provide the service that they are paying for.

[Charis16]

You seem very entitled.

Thank God the patients have the blessed luxury of being able to have a moment of your time.

You provide a service, they are purchasing a service. No different than the plumber or roofer or auto mechanic. If you hate dealing in customer service then move to a profession that does no require you to deal with people.

Not entitled so much as wishing that admins would be on the nurses side instead of leaving notes in the bathroom stalls on everything we are doing wrong. It is nice to know that you are not viewed as disposable at your workplace when the department has worked our tails off to bring the score up from "good" to "very good." I don't mind working hard by any means but please let me know that this is the direction we are supposed to be going instead of leaving lovely notes of discouragement.

perhaps I do feel entitled that the staff should have more input than we currently do. I do not feel a single survey should dictate vast policy changes as it does at the hospital I work at.

Yes I could move hospitals but considering other circumstances it would not be favorable enough to outweigh my hope for the admins to care.

I love nursing, and I fine with providing excellent customer service but our hospital has all but forgotten the medical side of things. That we are still a hospital. There was an investigation about a pt. complaining he was delayed for his outpatient MRI. When he was told an emergency had come up, they were very sorry and would do there best to work him in now at the other facility or immediately after the emergency he told them this was unacceptable and filled out the survey with zeros. An emergency, multiple aplogies, offers to try to fix the problem and still not good enough reasons? Admins want to know why he was delayed and how we can fix it. When I look at it I don't see a giant customer service error like they do. I see people who are trying their very best to take care of patients and provide customer service. I just wish admins could see it is still medicine - emergencies come up and schedules change, as much as we wish we could control it we can't. I just wish admins would stop making heads roll for this one person being unhappy about being bumped by the ER. I wish they would remember medicine is still involved.