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Patient Satisfaction
JEFFREY LEESER/thanks to LaSalle University in Philadelphia
Patient Satisfaction
Scores
Optimizing the patient and clinician
experience
By Christy Dempsey, MSN, MBA, CNOR, CENP
PATIENT SATISFACTION scores. These three words often strike
fear—and sometimes anger—in the hearts and minds of nurses. In
1985, when Irwin Press and Rod Ganey developed Press Ganey’s
first scientifically rigorous, validated survey and began to use the
resultant data to measure patient perception of hospital care, the
goal was for facilities to understand that perception and improve
it. However, many hospitals began to focus too heavily on raising
their patient satisfaction scores and not enough on ensuring a
positive patient experience.
Although high patient satisfaction scores are important, achieving
high scores should not be our overall goal, and the survey
data should not be our sole focus. Our overall goal should be to
reduce the suffering experienced by patients, their families and
their caregivers.
Patient satisfaction scores should reflect how well patient needs
are being met.
A Focus on Satisfaction
When Press Ganey embarked on its mission to measure the patient
perception of care, nurses would hand out the Press Ganey survey
as the patient was discharged from the hospital and the patient
would complete the survey and mail it back. Hospitals began to
see that patient feedback was important, and they started to drive
accountability by using patient satisfaction scores as metrics that
influenced clinician performance appraisals and
compensation.
Clinicians then began to find fault with the data,
argue the results, and discount the numbers, saying
things like, “How can the patient know whether
I’m doing a good job?” or “I’m always nice, they’re
just needy.” In fact, as a nurse working the 3-to-11
shift in a busy neuro/trauma stepdown unit, I would
carefully choose which patients received the survey.
I based that selection on who I thought would give
me the best scores, and then I would punctuate the
encounter with something like, “Now, remember
what your mother always told you: If you can’t say
something nice, don’t say anything at all!”
Fast-forward to today, and the survey process is
automated. It is also critically important. Even the
federal government has concluded that soliciting
patient feedback is essential. In fact, the Institute
for Healthcare Improvement has determined that
improving the patient experience is one of the
three dimensions of its “Triple Aim” for healthcare
quality (the other two are to improve outcomes
and to reduce healthcare costs).
Survey data is not simply data. It is the patient’s
evaluation of his or her care. Every patient voice
matters.
Refocusing on the Experience
It’s clear that the patient experience is about much
more than patient satisfaction. It involves more
than superficial, consumer-focused remedies that
may provide short-term positive results but not
long-term sustainable improvement.
Rather, the patient experience is inextricably
linked to clinical quality and safety, and all three
are nursing-sensitive. Reducing patient suffering
requires a level of clinical quality that keeps
patients safe and provides evidence-based, highquality
care in the most efficient manner. This
quality care must bring to life the behaviors that
exemplify engagement and caring and ensure that
the shared purpose of mission, vision and values
drives the culture of the organization.
Press Ganey’s Compassionate Connected Care
model changes the conversation around patient
experience. The model’s six themes help reconnect
clinicians with purpose and meaning. They
remind us that nursing is a calling, not a job, and
that our patients are people who are at their most
vulnerable. The themes are:
• Acknowledge suffering: Show them we
understand.
• Body language matters: Nonverbal communication
is as important as words.
www.advanceweb.com/Nurses n MAY 2016 n ADVANCE FOR NURSES 33