Four Areas to Target Including One Surprise
Patient satisfaction can seem like an ephemeral thing. Is there anything tangible you can focus on to boost it?
Several studies have indicated that yes, yes there is. It is all about getting back to the basics. It appears that by focusing on things that improve safety and caring, patient satisfaction scores will rise as well.
A review published in the British Medical Journal in 2013 looked at 55 studies that measured care and patient satisfaction in several types of healthcare settings. The idea for the review came about in an effort to answer the question: should patient satisfaction even be used as a measure to rate hospitals?
The review found that, higher patient satisfaction scores were often linked to higher safety and clinical efficiency scores.
“Overall, it was more common to find positive associations between patient experience and patient safety and clinical effectiveness than no associations,” said the authors.
If patient satisfaction scores were high, the same hospital was likely to have high patient safety and patient experience scores as well.
Results from a Patient Safety and Quality Care survey of studies in 2008 speculated that this might be because the same things that help prevent serious complications, patient identification errors, infections, medication errors and falls also happen to improve patient satisfaction.
What Steps Can Your Emergency Department Take to Improve Safety, Caring and Satisfaction?
There are many things you can do and I am happy to talk to you about a unique plan for your hospital but for the purpose of this post, we’ll take a look at four biggies.
1) Take a look at communications. Make sure you have procedures in place to make communication of patient information easy. Areas to look at? Transfer of information between caregivers, shifts and different departments within your hospital. Looking at your procedures for intake and discharge can be especially effective.
Nursing leaders, you can reinforce the importance of communication in your rounding and bedside reporting to oncoming nursing staff. Modelling this behavior yourself -- leading by example -- can help ensure the whole nursing staff adopts this approach.
2) Make sure staffing coverage meets the demand for patient care.AHRQ’s Patient Safety Network has concluded what most of us know -- nurses are critical in ensuring patient safety. So let’s help set them up for success. Staff that aren’t pressed for time and stressed running from one emergency to the next has the time to provide quality care. Appropriate coverage also minimizes mistakes.
So how can you make this a reality? Experienced nursing leadership knows the wisdom of a data-driven staffing and scheduling approach. You can use healthcare analytics to understand demand and your functional capacity to solve your staffing challenges.
3) Encourage an environment of trust and non-judgmental for reporting errors. Staff is less likely to report errors or perform well when there is a “blame game” type of atmosphere. Patient safety and satisfaction suffer. Fostering the right culture can help remedy this.
A “just culture” -- one that strikes the right balance between openness and accountability -- improves safety without being arbitrarily punitive. The Leapfrog Group, a circle of large employers focused on improving health care safety, has recognized the importance of a fair and just culture in improving safety.
There is a methodology and algorithm you can apply to help you implement this type of culture and spell out guidelines for appropriate actions when errors are made.
4) Limit noises to promote healing and focus. This one may come as a bit of a surprise. Patient satisfaction surveys tell us patients are not as happy in loud environments. Studies have found that noise hinders healing, causes sleep deprivation, and increases pain.
So upon a second look -- it also makes sense that chaotic unscripted emergency department noise can compromise safety. Researchers have found that louder healthcare environments produce more medical mistakes. It makes it hard to concentrate, may desensitize staff to important alarms, and interferes with the effective communication between caregivers. The Joint Commission made a National Patient Safety Goal on managing clinical alarms systems in 2014. They recognized that if they are not properly managed, they can compromise patient safety.
To take control of noise you need to understand it. Every interaction, every piece of equipment, every medical alarm, every emergency page, and every phone creates noise. Even patients, visitors and others add to it.
To solve this multi-faceted problem, engage everyone in pinpointing sources of noise and taking personal responsibility to limit it. Sometimes changes to the physical environment can help too.
So Why Does Improving Safety Yield Other Benefits?
None of the study authors pinpointed the whys behind the link between good safety scores and high patient satisfaction. Perhaps emergency departments that rate well on patient satisfaction measures are also paying more attention to safety rules too.
Or maybe it is because people go to emergency departments to get better. When adverse events are kept to a minimum and safety is a priority, people are more likely to improve and heal. It’s natural that those patients will be more satisfied.
What I do know for sure is that when you invest in improving processes and communication to improve safety and care it can yield a double-win!
If you need help examining safety protocols or your patient satisfaction survey results and finding ways to improve, I can help. Contact me. I’d love to talk over your emergency department’s unique situation with you.
Patient Safety and Quality Healthcare: “Safety and Satisfaction: Where are the Connections?”
BMJ Open: “A systematic review of evidence on the links between patient experience and clinical safety and effectiveness.”
AHRQ PSNet: “Nursing and Patient Safety.”
Hospitals and Health Network: “Runaway Noise in the Hospital.”
New England Journal of Medicine: “Balancing "no blame" with accountability in patient safety.” Wachter RM, 2009.
The Joint Commission: “The Joint Commission Announces 2014 National Patient Safety Goal.”