I wrote The dirty secret that is destroying nursing after an extremely challenging day at work.
I absolutely love nursing and patient care, it truly is a blessing to be able to serve our patients.
There have been many different reactions from the article and I would like to address some of them. It isn’t so much providing patient experience that is destroying Healthcare as it is surveys that are tied to reimbursement, that actually set us up for failure.
I read an article posted on mighty nurse the other day that was a prime example of the misunderstanding.
Every Healthcare provider wants to provide the best care possible and at the end of the day knowing we were able to aide those who are suffering is very rewarding.
When I first read this post about saving nursing I was of course upset, patient experience is in no way saving us, after reflection I realize there needs to be further explanation to those nurses or Healthcare providers that don’t understand why it has so many of us up in arms”.
Surveys are great for some services, but Healthcare is a complicated subject when it comes to customer service, this isn’t taking your car into have services done to it, this is your body. There is a study from the University of California-Davis that examines the trues cost of patient satisfaction.
To quote the conclusion of the study, “in a nationally representative sample, higher patient satisfaction was associated with less emergency department use but with greater inpatient use, higher overall health care and prescription drug expenditures, and increased mortality” (Fenton, 2012).
In another article a senior Gallup excuse wrote in a 2002 letter to the CBS that the response rates maybe “too low to produce results” and stated “this is a dirty little secret in our industry” (Falkenberg, 2013). These surveys that are filled out by patients are rated and validated monthly.
All areas of Healthcare have their own systems, anyone working in Healthcare has heard of Gallup, HCAPS, Press Gainey. Here is one important part of any customer service style survey, it is based on perception. As we all know everyone has a different perception of quality care.
The second problem with surveys is the number of surveys that come back, this means that when looking at ratings those could be based off 3 returned surveys or 300, it can be misleading to look at scores alone.
So why would the government decide to use this as a guide to reimburse hospitals?
Pretty simple that way it can find ways to reduce payments made by CMS and Medicaid, however, in one aspect it has backfired because physicians are more apt to order costly test or admit patients that don’t meet inpatient requirements.
My issue isn’t customer service, it is the unrealistic expectations of these survey questions. Why is healthcare a pay by performance field now? This opens the doors across the board, I want to have government be paid by performance with voters surveys of questions that are impossible you meet, such as did you politician a attain all the promises he/she stated they would during election?
Honestly, we can’t go to any other business and say that the service wasn’t up to par and refuse to pay for services rendered.
So what can we do? We can make a change, there are millions of nurses alone. We make and stand and demand a change in the survey.
People that don’t even understand our field are grading and judging us? As nurses we need to come together to help protect our profession.
Falkenberg, K. (2013, January 2). Why Rating Your Doctor Is Bad For Your Health. Retrieved March 16, 2015, fromhttp://www.forbes.com/sites/kaifalkenberg/2013/01/02/why-rating-your-doctor-is-bad-for-your-health/
Fenton, J. (2012, March 12). The Cost of Satisfaction. Retrieved March 16, 2015, from http://archinte.jamanetwork.com/Mobile/article.aspx?articleid=1108766