Don't Let Nurses Sink Your Bottom Line

Because higher patient satisfaction scores translate to higher HCAHPS scores and Medicare reimbursements, how nurses interact with patients has a significant impact on a hospital's bottom line.

7 comments on "Don't Let Nurses Sink Your Bottom Line"
Nora O'Neill (5/24/2013 at 2:19 PM)

I appreciate the other comments recommending a broader view of influencing factors on a patient's experience within a hospital. I'm very uncomfortable with the title of this article as it is laden with negative connotations. Many, if not most, nurses prefer to have a strong rapport with patients & families. Healthcare is in the midst of an overhaul due to faulty systems. Be global in your view, please.
Lisa S. (5/24/2013 at 9:07 AM)

I agree with Lisa's comments. Organizations must create environments to fully engage patients in ways that contribute to overall quality. We have been lured into believing patient satisfaction scores are indicators of quality care, and go so far as to reimburse based on satisfaction scores. Studies do not positively correlate patient satisfaction scores with quality outcomes. If reimbursement depends on patient satisfaction, the satisfaction rating tools need to more closely align with quality indicators.
corelibrary (5/23/2013 at 12:39 PM)

I am not sure I like the title to this article. "It takes a village to care for one patient" and nurses are not the bottom line for pain alleviation[INVALID]they need a medical order for medication from the MD. The team approach with open communication should be fostered and collaboration and efficiency to care.
Beth Lincoln (5/23/2013 at 11:23 AM)

Interesting article which highlights communication between nurses & patients but not identifying variables that may influence the scores. I appreciate Lisa's comment that "organizations are not fostering cultures that value patient engagement." Perhaps that is the place to begin.
Lisa Sams RNC, MSN (5/22/2013 at 10:25 AM)

There are important "take aways" from both the PG study and this article but let's not miss the message about patients' perceptions which the HCAPS is suppose to capture. Do our patients feel safe, cared for, and do we aid their comfort? Nurses are indeed key to the overall score but if our organizations are not fostering cultures that value patient engagement then we will never get it right because the focus will be on the scores not on the outcomes for better care. Ken's comments reflect some of the underlying dynamics that can lead us in the wrong direction if we are really interested in improving the way care is provided. There is a real danger in reactive thinking to these surveys; the tool is flawed and response rates vary but they are here to stay. So it is nursing's opportunity to lead a path forward by articulating the issues that need to be addressed, offering solutions with some cost analysis, and expecting our organizations to move to patient centric care.
Audra LaFitte (5/22/2013 at 1:38 AM)

I guess the thought of adequate staff which would allow for a stress free nurse, time for bathroom breaks, and a real lunch break would create an environment which propagates nurse who are happy to be at work, fast and responsive answering of call lights and there fore happier patients?
Ken Nelson III, DNP, RN, NE-BC (5/21/2013 at 1:44 PM)

Your framing of this data, as well (as the title of your article) give the impression that nursing is the sole owner of the patient experience. In the June 2012 issue of JONA, three Press Ganey scientists published a study titled "Nursing Care, Inpatient Satisfaction, and Value-Based Purchasing." In addition to the large impace that the nursing domain has on overall satisfaction, the study also showed that the aesthetics of the room as well as things like meals, how personal issues were handled, and (yes) physician interactions all played a role in achieving an overall top box score. If an organization has a steadily increasing nursing domain on HCAHPS, while the physician domain remains flat, should the organization ignore the data simply because the physician domain has a lower statistical probability of raising an overall score? It should be clear that ALL health care team members own their share of the patient experience. I think a more appropriate title for your article might be "Don't Let Disciplines Not Practicing at the Top of Their Game Sink Your Bottom Line."


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