HCAHPS

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Communication on Medications Effects HCAHPS Scores and Patient Safety

Communication with patients on medications is important for both patient experience HCAHPS scores on the HCAHPS survey AND patient safety.

The two questions the HCAHPS survey asks with regards to communicating on medications are:

“How often did the hospital staff explain the purpose of the medication?”

“How often did the hospital staff explain the side effects in a way that the patient could understand?”

Communication and HCAHPS Scores

Data indicates that there is a big disconnect between patient education efforts and what patients are actually learning. A recent survey of patients at discharge showed that when they went home, a third of the patients did not know the purpose of their medications, and that 86% did not know the side effects of their medications. That is a problem.

hcahps scores

 

How do we tackle it? It starts with slowing down the process for administering medications. Take time to allow the patient to ask questions, and give yourself enough time to give complete answers. Make sure that patients are well educated on their medication, and use the same process for every patient, every time. The process consists of four main elements.

  • Name of the medication
  • Dosage
  • Purpose of the medication
  • Any side effects that go along with that medication

It may seem incredibly repetitive to say the name, dosage, purpose, and side effects of each medication every time, but the HCAHPS survey question doesn’t ask, “Did the staff member occasionally give those key points for medication?” Rather, it asks, “how often,” and the answer should be “always” for every patient, every time.

Communication on Medications Training Video

Give your staff the skills they need to clearly and consistently communicate with their patients on medication. This lifetime license is deeply dicounted right now for only $47.

Click here to access the Communication on Medications Training Video

If your patients can repeat back the name, dosage, purpose, and side effects, you can be sure that they will indicate “always” when asked about medication education on the HCAHPS survey. While the focus of these tactics is on the patient’s answer to the survey question, the ultimate end goal is a patient who is more educated on their own medications.

$47 - Communication on Medications Training Video

The 8 Most Common Root Causes of Medical Errors

A recent study from Johns Hopkins suggests that medical errors are now the third-leading cause of death in the U.S., having surpassed strokes, Alzheimer’s, and diabetes. In addition, one in seven Medicare patients receiving care in a hospital are victims of a medical error. However, medical errors can occur in almost any healthcare setting including hospitals, clinics, surgery centers, medical offices, nursing homes, pharmacies, and patients’ homes. This post will explore the most common causes of medical errors.

root causes of medical errors

A few of the most common types of medical errors include: medication errors, errors related to anesthesia, hospital acquired infections, missed or delayed diagnosis, avoidable delay in treatment, inadequate follow-up after treatment, inadequate monitoring after a procedure, failure to act on test results, failure to take proper precautions, and technical medical errors.

Studying these mistakes, learning how to prevent, monitor, and respond to them is key to changing the standards of care. By working to eliminate common medical errors, healthcare systems and providers can protect patients, protect themselves, improve standards of care, and lower costs.

Communication on Medications Training Video

Give your staff the skills they need to clearly and consistently communicate with their patients on medication. This lifetime license is deeply dicounted right now for only $47.

Click here to access the Communication on Medications Training Video

According to the Agency for Healthcare Research and Quality, there are eight common root causes of medical errors which include:

Communication Problems

Communication breakdowns are the most common causes of medical errors. Whether verbal or written, these issues can arise in a medical practice or a healthcare system and can occur between a physician, nurse, healthcare team member, or patient. Poor communication often results in medical errors.

Inadequate Information Flow

Information flow is critical in any healthcare setting, especially within different service areas. Insufficient information flow happens when necessary information does not follow the patient when they are transferred to another facility or discharged from one component or organization to another. Inadequate information flow can cause the following problems:

  • The lack of crucial information when needed to influence prescribing decisions.
  • Lack of appropriate communication of test results.
  • Poor coordination of medication orders for transfer of care.

Human Problems

Human problems occur when standards of care, policies, processes, or procedures are not followed properly or efficiently. Some examples include poor documentation and labeling of specimens. Knowledge-based errors also occur when individuals do not have adequate knowledge to provide the care that is required at the time it is needed.

Patient-Related Issues

These may include inappropriate patient identification, inadequate patient assessment, failure to obtain consent, and insufficient patient education.

Organizational Transfer of Knowledge

These issues can include insufficiencies in training and inconsistent or inadequate education for those providing care. Transfer of knowledge is critical in most areas specifically where new employees or temporary help is used.

Staffing Patterns and Workflow

Inadequate staffing alone does not lead to medical errors but can put healthcare workers in situations where they are more likely to make a mistake.

Technical Failures

Technical failures can include complications or failures with medical devices, implants, grafts, or pieces of equipment.

Inadequate Policies

Often, failures in the process of care can be traced to poor documentation and non-existent, or inadequate procedures.

$47 - Communication on Medications Training Video

References:

A Simple Way to Foster Medication Adherence

Educating Patients on Medication Adherence

Medication non-compliance causes nearly 125,000 deaths in the United States and costs an estimated $290 billion annually. In fact, the number of patients who are non-compliant has reached epidemic proportions and is increasingly considered to be one of the most pressing issues in healthcare today. Research from the National Council for Patient Information and Education suggests that roughly 50% of patient prescriptions are taken incorrectly or not at all.

One survey found that a third of patients discharged, did not understand the purpose of their medications when they went home, and 86% of patients did not know their medications side effects. Consequently, there has been a breakdown between the communication of medication instructions and what patients are comprehending.

Patient adherence to a medication regimen is critical to good patient outcomes. Effective provider/patient communication is also critical to positive outcomes, patient satisfaction, health status, and adherence. According to the Agency for Healthcare Research and Quality, educating patients before they leave the hospital can decrease readmissions, reduce unnecessary visits to the ER, and lower costs.

Although medication adherence is a complex issue, research suggests that simple interventions are the most effective in fostering medication adherence. The American College of Preventative Medicine recommends using the mnemonic SIMPLE, to help improve patient adherence.

  • S imple regimen
  • I mpart knowledge
  • M odify patient beliefs and human behavior
  • P rovide communication and trust
  • L eave the bias
  • E valuate adherence

S – Simple regimen. A complex treatment can affect patient compliance. Which is why providers should consider trying a simple regimen whenever possible. Medications taken once-a-day, or at the same time of day are usually preferred. However, the regimen should also coincide with the patient’s daily activities. Encourage the use of aids such as medication organizers and alarms.

I – Impart knowledge. Adherence is increased when patients are knowledgeable about their conditions and the benefits of treatment. A few best practices include:

  • Focus on shared decision-making.
  • Provide clear, written, and verbal instructions for all prescriptions.
  • Speak in common terms and try not to use medical jargon.
  • Include the use of written information or materials.
  • Include family and friends when appropriate.
  • Offer quality online references for patients that wish to seek health information from the web.

M – Modify patient beliefs and human behavior. Patient education alone is not enough to improve patient adherence. Engaging patients in an open dialogue about their expectations is also necessary.  Address any fears or concerns the patient may have about taking the medication. Empower patients to self-manage their condition and ensure they are clear about the risks of non-compliance.

P – Provide communication and trust. A physician’s communication style is one of the key factors to winning patients trust. Best practices for enhancing communication include:

  • Improve interviewing skills
  • Practice active listening skills
  • Provide emotional support
  • Provide clear, direct, and thorough information
  • Encourage the patient’s input in treatment decision-making
  • Allow time for patients to ask questions ‘
  • Build trust

L – Leave the bias. Physician interventions that increase patient/physician partnership are important strategies to overcome disparities. For example:

  • Encourage practice to learn more about low health literacy and how it affects patient outcomes
  • Review communication style to see if it is patient-centered
  • Understand the demographics of a patient population
  • Ensure patient communication and education is tailored to the patient’s level of understanding

E – Evaluating adherence. The problem of nonadherence is often underestimated. However, if it isn’t suspected, it cannot be corrected. Measuring adherence can lead to better patient compliance and can be implemented through self-reports and simply asking patients directly if they are following their drug regimen.

5 Areas of Focus for HCAHPS eBook

References :

[PODCAST] Causes and Solutions for the Nursing Shortage

Unless you live under a rock, you already know there is a serious nursing shortage in this country. The Bureau of Labor Statistics currently estimates a deficit of nearly one million nurses by the year 2022. Nursing shortages are not new, but this one is different from some of its predecessors. Previous shortages, like the one seen in 2001, were more about a lack of supply. In other words, fewer people were choosing to make nursing their career.

Listen to the podcast and see our related podcast to learn more:  Causes and Solutions for the Nursing Shortage5 Areas of Focus for HCAHPS eBook




Causes and Solutions for the Nursing Shortage

nursing shortage

Unless you live under a rock, you already know there is a serious nursing shortage in this country. The Bureau of Labor Statistics currently estimates a deficit of nearly one million nurses by the year 2022. Nursing shortages are not new, but this one is different from some of its predecessors. Previous shortages, like the one seen in 2001, were more about a lack of supply. In other words, fewer people were choosing to make nursing their career.

The cause of the current shortage is actually three-fold: an aging population, an aging workforce, and a limited supply of new nurses.

  • An Aging Population– The baby boomers are going into their golden years. It is estimated by between 2010 and 2030, one in every five people will be a senior citizen.
  • An Aging Workforce– As the population ages, so do the nursing staff. Approximately one-third of the current nursing workforce is 50 years or older.
  • A Limited Supply of New Nurses– There is a limit to the budgets and staff of nursing schools resulting in a bottleneck of graduating students. In other words, there are only so many new nurses entering the workforce each year and it’s not enough to cover the deficit created by those who will soon retire.

So, what can employers do to manage this escalating nursing shortage?

Short-Term Methods for Hospitals

Currently, employers are incorporating financial incentives into their hiring such on as sign-on bonuses, as well as offering financial rewards to encourage nurses to work more or bring in traveling nurses. These, of course, are short-term solutions at best; temporarily fixing the problems and at a high cost for the hospital.

Recruiting the Top Nursing Talent

Today, hospitals must focus must be on recruitment: finding ways to draw in the best prospects and keep them.

Administrators should begin by figuring out what separates their facility from all the other. In terms of facilities and technology, there is a relatively level playing field across the country, so what will make one employer stand out from all the others? It’s the culture that will appeal to the best nursing talent, and that means:

Culture can be an elusive concept, but it really boils down to a few basic things:

  • Transparency– An administration that is open and clear about what is happening in the facility, such as the logistics of the construction, the hospital’s finances, and its strategic goals. Providing this core information makes employees feel like they are part of the decision making process.
  • Appreciation– Going that extra mile to ensure employees feel appreciated for their work is a critical part of the culture, as well. This is true for every department from nursing to EVS.
  • Communication – This is the core component of establishing an enticing culture. Employees need to feel like the administration understands what they do and why. For nurses, the “why” will always be patient care and safety.

Creating a culture that supports, informs, and empowers its nursing staff to give the best care possible is what will separate one facility from another.5 Areas of Focus for HCAHPS eBook

[PODCAST] Introducing Tenured Staff to Value Based Care

How do more tenured nurses feel about value based care? It’s a question that challenges any person in a staffing and management position. The ideas of value based purchasing, raising HCAHPS scores, and patient satisfaction aren’t new for staff members in a hospital setting. For the nursing staff on the front lines, however; the concept is more complex. New nurses who join the team are adapting to many new concepts and processes, and these tactics and requirements for value based care are usually accepted as part of the job.

Listen to the podcast and see our related podcast to learn more:  Introducing Tenured Staff to Value Based Care5 Areas of Focus for HCAHPS eBook




Introducing Tenured Staff to Value Based Care

tenured staff and value based care

How do more tenured nurses feel about value based care? It’s a question that challenges any person in a staffing and management position. The ideas of value based purchasing, raising HCAHPS scores, and patient satisfaction aren’t new for staff members in a hospital setting. For the nursing staff on the front lines, however; the concept is more complex. New nurses who join the team are adapting to many new concepts and processes, and these tactics and requirements for value based care are usually accepted as part of the job.

The more tenured staff member, though, might be less adaptive. Veteran nurses tend to be skeptical and strive to find a reason for the change beyond just appeasing administration. They want to ensure positive outcomes, so they know they are not just wasting their time on a new process. Put simply, they need to know it is good for their patients. So, what can the administration do to get this important sector of the nursing staff on board with value-based care?

Current Value Based Care Tactics That Help

For starters, there are widely accepted patient care tactics that already support value-based care initiatives:

All three of these tactics work to improve patient safety, enhance communication and reduce errors. At the same time, they lower anxiety levels and improve patient and family satisfaction. Whether new or tenured, nursing staff members should have no problems using these tactics to bolster quality patient care and the patient experience.

Using Communication Boards

 

A relatively newer approach worth considering is the use of communication boards. These boards are not new, but they have a tendency to be underutilized. They can easily be ignored unless nursing management and administration are intentional about ensuring their correct use. If you are sensing push-back or apathy from staff members on utilizing communication boards, the best approach is education. Training should be reviewed on why they are used, but more importantly, it must be explained how it can change a patient’s outcome. Put simply, it reduces stress levels for both the patient and family members while improving communication between nursing staff going in and out of the room. Communication boards list everything from the patient’s room, to their schedule, to their medications, to names of their care team. Reiterate to your staff members that consistently using the communication boards will not only improve care team communication, but it will set expectations and calm anxieties for their patients.

Courtesy and Respect

Just the mention of this topic is likely to get eyes rolling, especially among more tenured nurses. Courtesy and respect are concepts often confused with the idea of “being nice”, but there is a big difference.

When patients enter a hospital, they lose all power. They can easily feel that they are unable to make decisions for themselves and are stuck somewhere they really don’t want to be. Treating them with courtesy and respect isn’t about being “nice” – it’s about letting them know that they still matter. Courtesy and respect then translate into making patients a part of their own care team. Once you bring them on board, they feel more comfortable to:

  • Ask questions that they might not have otherwise
  • Offer information they may have kept silent before

You give them back some of their power by making them part of the team.

To some staff members, value based care can feel like extra work or something that is just meant to check a box for administration—and from this perspective, it’s an understandable attitude. It is up to administrators and nursing managers to demonstrate to staff members how these initiatives will not only improve the patient experience but how these same tactics can improve overall care and patient outcomes.

5 Areas of Focus for HCAHPS eBook

[PODCAST] 5 Steps to Achieve Buy-in to Your Hospital’s Nursing Culture

Proper onboarding of new nurses is key to retention, job satisfaction, and engagement in complete patient care. Nurses who are comfortable in their environment, and feel supported by management, will become a critical part of the care team.

Listen to the podcast and see our related podcast to learn more:  5 Steps to Achieve Buy-in to Your Hospital’s Nursing Culture

5 Areas of Focus for HCAHPS eBook




5 Steps to Achieve Buy-in to Your Hospital’s Nursing Culture

Proper onboarding of new nurses is key to retention, job satisfaction, and engagement in complete patient care. Nurses who are comfortable in their environment, and feel supported by management, will become a critical part of the care team. These nurses have “bought in” to your hospital’s nursing culture and mission, and they feel empowered to provide the best possible healthcare to their patients. Excellent nursing care leads to improved patient outcomes, increased patient satisfaction, and higher HCAHPS scores. Solid nurse onboarding will engage new staff members — aligning them with your mission and vision in order to achieve your patient care and satisfaction goals.

nursing culture

Achieving Buy-in to Workplace Nursing Culture: 5 Steps

An analysis of a recent (2015) Press Ganey nursing survey, which received input from more than 200,000 nursing professionals, reveals five crucial elements that you must develop to spur nurse engagement:

  1. Patient-Focused Mission
    Nurses want to do meaningful work—it’s why they went into nursing. They want to help their patients, provide the best care possible, and they want to feel supported while they do it. As an administrator, you can do nothing more important for your staff or your patients than to create a patient-centered mission and vision for your entire organization. And while one of your goals may be to improve HCAHPS scores, it CANNOT be your main focus. The mission and overarching goals of your hospital must be focused on patient care, and empowering your staff to deliver that care — nurse engagement, quality care, patient satisfaction, and improved HCAHPS scores will all develop from there.
  2. Respect and Appreciation in the Workplace
    Nursing is a difficult job, and it is only made harder without a nursing culture of respect throughout the hospital. Mutual respect and teamwork are essential for great patient care. Nurses who feel that they are valued by their administration, and by their fellow staff members, are motivated to perform at the highest level. Make sure your organization finds opportunities to appreciate the staff and promote respect. Host events that thank staff members for their efforts and accomplishments. Offer meaningful recognition programs that notice and appreciate the nursing staff’s dedication to “go the extra mile”. Survey your staff to gauge their satisfaction and take action in areas where you have opportunities to improve. Working in an environment of mutual respect and demonstrated appreciation on a daily basis fuels positive patient outcomes and increases patient satisfaction.
  3. Supportive and Comfortable Work Environment
    A comfortable, clean, and updated physical workspace helps encourage and enable the nursing staff. A haphazard, disorganized and unkempt workplace leads to overstressed staff – and naturally, this can translate to the kind of care they provide. Paying attention to creating a positive mental workspace is also key. Nurses who anticipate respectful, supportive colleague and hospital management relationships will be excited to join your organization. The more obviously you model these traits, as well as provide training and counseling to achieve them, the happier and more engaged your nursing staff will be. Clearly articulate that management’s role is to take care of and support the nursing staff, so the nurse can concentrate on caring for the patient.
  4. Fair Pay
    Although not at the top of the requirement list for successful nursing, a fair pay structure is foundational to new nurse buy-in, and for nurse retention over time. Competitive pay demonstrates support and respect for the nursing staff, and it serves as a foundation upon which you can build your reputation and nursing culture.
  5. Attractive Career Paths and Development Opportunities
    One way to show that you appreciate and respect your nursing staff is to provide them with opportunities. Overwhelmingly, nurses want to use all their hard-won skills to the fullest, and they seek to develop new ones. Nurses want to advance in their careers and to have a greater impact on the patients they serve. Truly motivated and engaged nurses are not seeking dead-end jobs – they want to feel that becoming part of your organization includes future opportunities. They want to refine their abilities to an expert level, gain new skills and assume new responsibilities over time. Don’t just tell your nurses you support them, but show it in practice with financial support and opportunities to progress up the career ladder and to attain advanced certifications.

Melding the Five Elements for Nurse Buy-in

These five tips for achieving cultural buy-in are strongly interrelated, so even focusing on one of them will help advance your progress with the others. When a new nurse is considering joining your organization, whether a Millennial who is new to the profession–or an experienced nurse further along on the career path, articulate your patient-centered mission clearly. Tell them who you are and let them know the strength of the organization they are joining. Show them how you will provide the support they need so that they can deliver the best care possible.

5 Areas of Focus for HCAHPS eBook

[PODCAST] How Today’s Patients See Care Teams

Today’s patients see care teams differently than they once did. In the past, patients played more of a child-like role to their physicians and nurses. However, in today’s more patient-centered market, there has been a shift to patients wanting more information and control over their own care—they want to be a member of their own care team.

Listen to the podcast and see our related podcast to learn more: How Today’s Patients See Care Teams

5 Areas of Focus for HCAHPS eBook