The link between patient satisfaction and nurse satisfaction
Friday, June 05, 2015
On April 17, The Atlantic published an article entitled, "The Problem With Satisfied Patients." The subtitle of the article — "A misguided attempt to improve healthcare has led some hospitals to focus on making people happy, rather than making them well" — makes the focus of the piece quite clear.
Meanwhile, on May 22, the popular physician blogger known as Kevin MD published a blog post in response to The Atlantic article, his piece being titled, "Let's Celebrate Nurses by Reining in Patient Satisfaction."
These two articles underscore the reality that hospital reimbursements are now being linked to patient satisfaction scores. Even some physician and nurse salaries and bonuses are also apparently tethered to such measurements.
Satisfaction and health are not necessarily equal
Patient satisfaction is calculated utilizing many factors, and patients' unhappiness with food, cleanliness and other nonclinical aspects of their hospital experience certainly influence these ratings.
As noted in The Atlantic, one hospital's decision to switch to microwaved patient meals resulted in lower patient satisfaction scores, which the hospital administrators attributed to nurses' inability to "present and describe" the food more positively to patients.
While nurses are certainly interested in patients having a positive experience, there is no question that some patient experiences will be highly unpleasant. Moreover, if nurses are already stretched thin in terms of nurse-patient ratios and patient acuity, concerns regarding the quality of meals or housekeeping will no doubt be trumped by concerns for safety, accurate medication administration and documentation, and timely nursing care and intervention.
If patient satisfaction scores give equal weight to the quality of sandwiches and the accuracy of medication delivery, patients will have ample opportunity to negatively impact satisfaction scores based on aspects of their hospital stay that are not necessarily those that directly affect their morbidity or mortality.
The 'Disneyfication' of nurses
In some facilities, nurses have reportedly been instructed to memorize scripts to use in specific types of nurse-patient interactions.
Consultants that seem more appropriate for the hospitality industry are being hired to teach nurses and healthcare professionals about communication with patients. These experts with no clinical experience are creating situations wherein nurses feel like "Stepford nurses," forced to communicate in ways that may feel less than therapeutic, and potentially disingenuous.
Nurses are professionally trained in effective communication, and the movement toward the "Disneyfication" of nurse-patient communication may effectively decrease patient satisfaction in the bigger picture. Of note, it seems the Walt Disney Company has actually entered the fray as consultants to the healthcare industry.
Hospitals' focus on providing live music, VIP service for "loyal customers" and other amenities may, as The Atlantic states, utilize "pixie-dusted sleight of hand" to convince patients that their experience is worth a five-star rating. Thus, some facilities receive excellent patient satisfaction scores (ostensibly in response to such special services) despite atrocious clinical outcomes.
Focus on nurse satisfaction
A Health Affairs study cited by The Atlantic demonstrated clearly that increased nurse satisfaction has a direct correlation with higher patient satisfaction. Moreover, increased nurse staffing also positively impacts morbidity, mortality and other cogent patient outcomes.
Nurses are the backbone of the healthcare industry, and we can feed them disingenuous scripts or we can allow them to interact with patients in the therapeutic manner in which they are trained.
If the healthcare industry chose to focus with laser intensity on the workplace satisfaction and wellness of their front-line employees, there is no doubt patient satisfaction scores would elevate in concert with that of nurses.
Nurses can raise their collective and individual voices against such misguided practices. If we could make those nurses' work lives more manageable and satisfying, patients would benefit on every conceivable level, even without Disney involved in the conversation.
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