Improving Patient Satisfaction Scores

What happens when better still isn’t good enough? It’s a legitimate question many hospital leaders grapple with as part of the ongoing work to improve health care quality, safety, and patient experience. A recent Research Corner column noted that Virginia hospitals have made improvement in patient satisfaction scores, while some areas leave room for more. In the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) tool, which provides a national standard for information about patients’ experience with care, hospital care is measured  across 10 “domains” that correlate to things such as communication with nurses, information about medicine, and hospital quietness. Virginia hospital scores from 2016-2017 improved in 60 percent (six of 10) of domains when compared to the 2014 performance. However, other states appear to be improving more rapidly than Virginia. In national rankings, Virginia improved its scores in 50 percent (five of 10) of domains between 2014 and 2016. Improving 10 different scores is difficult, as is improving relative to other states. As Figure 1 illustrates, communication about medicine, nurse communication, and patient recommendations are the areas in which Virginia hospitals experienced a decline in the rankings. The possibility exists that these three areas are related – if patients are unclear about medicine prescribed to them, they may feel unprepared to manage their own care. This could even lead to an unnecessary hospital visit. Much of the teaching about proper medicine usage comes from nurses. When patients are unfamiliar with their medicine regimen, they will be dissatisfied with their nursing care. The teach-back technique can help address this issue. Teach-back is not limited to patients; family members who assist patients with their daily care are encouraged to learn along with the patient. This requires coordination to get all parties involved in the right place at the right time. As health care organizations work to improve coordination and identify the barriers to integrating a process like teach-back into the daily routine, hospitals are committed to addressing these and other patient care issues that can lead to dissatisfaction. Determining the cause of a decline in hospital recommendations from patients, for instance, can be challenging because the primary reason is rarely the same among the 800,000 patients discharged each year from Virginia hospitals. What the finding has generated is more sharing among hospitals to learn from each other and integrate successful strategies throughout the Commonwealth. Statewide, 72 percent of patients said they recommend their hospital. The state with the highest percentage of patients recommending their hospital is Nebraska at 79 percent. (11/30)

Figure 1.  National Ranking on Patient Satisfaction Domains