HCAHPS

HCAHPS articles, podcasts, ebooks, and downloads from Always Culture.


[PODCAST] Adjusting the Discharge Process for Improved HCAHPS Scores

,

There are five questions on the HCAHPS survey dealing with the discharge home, or the transition of care, and they all center around the patient’s level of understanding of their discharge instructions and your staff’s level of understanding of patient preferences. For improved HCAHPS scores, we need to recognize a problem with the discharge process: we, as health care providers, have designed the process for us and not for our patients.

Listen to the podcast to learn tactics for improving the discharge process or checkout the full video and article: Adjusting the Discharge Process for Improved HCAHPS Scores

5 Areas of Focus for HCAHPS eBook




4 Requirements for Effective Pain Management and Patient Satisfaction

What does it mean to control pain?

patient satisfaction through effective pain managementPain is almost a universal symptom for our patients, and depending on their coping mechanism and pain threshold, each person experiences pain in their own way. Naturally, a patient’s pain can affect their experiences and perceptions, but it should also be noted that the patient’s environment and experiences can also affect their pain.

In a study by the American Pain Society, it was noted that patients reported worse pain when they perceived their providers to be uncaring.  This study also showed that the effect can work positively as well.  Patients reported that their pain was effectively controlled when expectations were set, they were informed and included in their pain management plan, and staff frequently assessed their pain.

When a patient’s pain is effectively controlled they are more comfortable, more willing participate in their care, and are more likely to have good outcomes. Clearly, pain can affect our patients’ mind, body, and spirit, not to mention how they perceive their pain management and overall care.

What does it mean to effectively manage and control pain? It may not be what you think.

In a study by the Gallup Business Journal, it was noted that not only are certain levels of pain necessary for diagnosis, but it showed that it is not necessary to completely eliminate a patient’s pain in order for a them to perceive that their pain was well controlled.

Clearly, effective pain control is not about completely eliminating pain, nor is it about just giving meds. It’s about building trust by listening, communicating, and working with our patients to set realistic pain goals.

In upcoming posts on pain management, we will be addressing four main tactics and best practices. These four key needs for effective pain management are:

            Hospital Culture / Staff Attitudes

Not only do we need to eliminate the automatic labeling of patients as “addicts” or “drug seekers”, but we must respect our patients enough to partner with them, not just simply placating their pain complaints.

            Setting Patient Expectations and Goals

Trust and honesty are essential to making a pain control plan with our patients. We need set expectations and communicate with our patients that pain control does not mean completely eliminating pain, but it means reducing  pain to a manageable level.

            Consistency & Medication Administration Processes

As with any patient quality or patient satisfaction initiative, consistency is key. Specifically, we need to be consistent in the repetition of a scripted medication administration process.

            Administration Buy-in & Leadership

No initiative, policy, or best-practice can survive and be successful without solid front-line leadership and a strong sense of buy-in from hospital administration.

These tactics and best practices do not highlight specific pain control methods. They are ways to include your patient in their care, set their expectations, educate them on their own medications, and ensure that you are doing all you can to control their pain.
5 Areas of Focus for HCAHPS eBook




[PODCAST] Effective Pain Management for HCAHPS Improvement

,

Nearly every patient that comes into the hospital arrives with pain. Controlling pain and working towards HCAHPS improvement can be a challenge.

The HCAHPS survey asks two questions with regards to pain management:

“How often was your pain well-controlled?”

 “How often did hospital staff do everything they could to help you with your pain?”

Listen to the podcast to learn tactics for improving pain management techniques or checkout the full video and article: Effective Pain Management for HCAHPS Improvement


5 Areas of Focus for HCAHPS eBook




[PODCAST] Communication on Medications Effects HCAHPS Scores and Patient Safety

,

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

Listen to the podcast to learn tactics for improving communication on medications or checkout the full video and article: Communication on Medications Effects HCAHPS Scores and Patient Safety

5 Areas of Focus for HCAHPS eBook




[PODCAST] The Metric that Most Correlates with Overall HCAHPS Ratings

,

When a patient sits down with their HCAHPS survey to answer questions on how they communicated with their nurses, they’re going to be answering questions based on just about every communication they had with all staff members at the hospital…

Listen to the podcast to learn tactics for improving patient communication with nurses or checkout the full video and article: The Metric that Most Correlates with Overall HCAHPS Ratings

5 Areas of Focus for HCAHPS eBook




[PODCAST] 2 Key Measurements for the HCAHPS Survey Responsiveness Score

,

The HCAHPS survey asks about the measure of responsiveness in a very specific way. It doesn’t ask about responsiveness as it relates to how food trays are delivered, how medications are handled or how transportation is provided throughout the hospital. The HCAHPS survey asks about responsiveness in two specific areas…

Listen to the podcast to learn what those are and for steps on improving your Responsiveness Score or checkout the full video and article: 2 Tactics for Improving HCAHPS Scores AND Overall Patient Experience

5 Areas of Focus for HCAHPS eBook




[PODCAST] 2 Tactics for Improving HCAHPS Scores AND Overall Patient Experience

,

What does it take to create a great patient experience and promote HCAHPS scores that reflect high quality of care?

Patient experience is subjective. It’s subjective for you, for me, and for anyone who’s lying in a hospital bed. Every individual perceives their care differently, and that’s the challenge.

Listen to the podcast, or checkout the full video and article: 2 Tactics for Improving HCAHPS Scores AND Overall Patient Experience

5 Areas of Focus for HCAHPS eBook




Adjusting the Discharge Process for Improved HCAHPS Scores

The unfortunate truth is that no patient wants to be in your hospital and everyone is focused on going home.

There are five questions on the HCAHPS survey dealing with the discharge home, or the transition of care, and they all center around the patient’s level of understanding of their discharge instructions and your staff’s level of understanding of patient preferences. For improved HCAHPS scores, we need to recognize a problem with the discharge process: we, as health care providers, have designed the process for us and not for our patients.

Start at Admission

Patients need discharge information sooner than the last day of their stay. Why not start the process at admission? Start talking immediately with your patients about: 

  • Who are they going home with?
  • Who is their primary caregiver?
  • Do they need equipment?
  • Do they need extra help?

These questions should be addressed right from the beginning of their stay.

improved hcahps scores

Written Instructions

Every facility has a written packet of discharge instructions that includes precautions for going home and information on medications. This critical information should be presented at the beginning of a patient’s stay so that more education can take place and any questions that come up can be answered long before the patient walks out the door.

It’s true that medications can change toward the end of the stay, but why not start by giving them the precautions for the surgery that we know they’ve already had? Give them information on the medications we know they’ll be going home with, and not just for them to have it, but for us to reference it. Every time staff visits the room to discuss and administer a medication, it’s a great opportunity to pull out the discharge information.

Ideally, at the hour of discharge, the patient should be able to tell you about their precautions and medications rather than the other way around.

Proven Process

The discharge process should be repeatable for every patient, every time. Yes, discharge instructions should be discussed throughout the entire stay, beginning at admission, but at that moment of discharge there are six main steps that should be followed:

  1. Discuss the diagnosis.
  2. Follow up with any treatments that were done and the results of those treatments.
  3. Go over any test results.
  4. Discuss any symptoms that they can look for when they go home.
  5. Discuss any follow-up appointments.
  6. Go over instructions on any medications that will be taken at home. Medication Communication is a primary focus of the HCAHPS survey.

This is a process (for patients and improved HCAHPS scores) that should be repeated for every patient at every discharge, but more importantly, remember to start discharge planning at admission, and keep the conversation going throughout the entire stay.

5 Areas of Focus for HCAHPS eBook




Effective Pain Management for HCAHPS Improvement

Nearly every patient that comes into the hospital arrives with pain. Controlling pain and working towards HCAHPS improvement can be a challenge.

The HCAHPS survey asks two questions with regards to pain management:

“How often was your pain well-controlled?”

 “How often did hospital staff do everything they could to help you with your pain?”

Remember, these answers are on a scale from never to always, so consistency is the key.

HCAHPS Improvement & Pain Management

What does it mean to effectively control pain? It might not be what you think. To effectively control pain (or work towards HCAHPS improvement), we do NOT need to completely eliminate a patient’s pain. In fact, there are certain levels of pain that are necessary for diagnosis. More importantly, studies have shown that patients do not need to have their pain eliminated to experience good pain management. To manage pain effectively, patients need to feel that they have a partner, someone who is working with them on their pain management plan, listening, and having an ongoing conversation about progress.

hcahps improvement and pain management

 

Check Your Attitude

As caregivers who have seen hundreds if not thousands of patients talking about pain, it’s all too easy to start stereotyping patients as “drug-seekers” or other negative labels. Resist that temptation. It is incredibly important to give each patient a fresh start so that we can adequately listen to what they’re saying.

Be Honest-Set Attainable Goals

Let your patients know that you’re not going to completely eliminate their pain, but work with them in making a reasonable, attainable, and functionsl pain goal. A pain goal might be a certain level on the visual analog scale, to get from an 8/10 to a 3/10. It might be a functional goal, such as walking in the hall without pain, or walking in the hall a certain distance, or even sleeping through the night without pain. The idea is to find an attainable goal that works for them.

When you set these goals, use the administration time of medications to set their expectations.  After reviewing the medication name, dosage, purpose and side effects, try using a statement like, “I’d expect that in 45 minutes you should be feeling better and your pain level should be decreasing, and I’ll come back then to check on you.” This sets the expectation that you are partnering with them to get the best pain management possible, but you’re not a magician who can make pain disappear. Communication regarding medications is key for multiple parts of the HCAHPS survey.

Alternative Pain Control Methods

The second question on the HCAHPS survey relating to pain management asks, “Did this hospital staff do everything they could to help manage your pain?” That’s a big question. How do you quantify “everything we could?” It’s another one of those vague questions that can be a little frustrating for caregivers. The idea is not necessarily to do one particular thing, but it’s to do everything you can. Some patients may want a non-pharmacological or alternative pain control method. It could be anything from hand-holding to acupuncture, to changing a position, to aromatherapy or music therapy. Your facility may have different solutions available to them, but it’s the idea that you’re going to try to do something, rather than just giving them a pill to take. If they feel that you’ve at least tried something, they’re going to feel that you’ve done everything you can.

The main takeaway to employ with pain management (and HCAHPS improvement) is to simply be honest. Tell your patients that you can’t completely eliminate their pain, but you can work with them to set a goal that is attainable.

5 Areas of Focus for HCAHPS eBook




The Metric that Most Correlates with Overall HCAHPS Ratings

When a patient sits down with their HCAHPS survey to answer questions on how they communicated with their nurses, they’re going to be answering questions based on just about every communication they had with all staff members at the hospital.

In terms of HCAHPS ratings, the questions they’re answering are:

Were you treated with courtesy and respect?

How often were you listened to, and how often did nurses explain things in a way you could understand?

Remember that as patients answer these questions, they are indicating if communication “never” happened or if it “always” happened, so consistency is the key.

COURTESY & RESPECT

A big part of conveying courtesy and respect is eye contact and open body posture. Even sitting down at the bedside is much more effective than standing up and looking down at a patient.
Research even shows that patients feel that they were listened to more, and that their questions and concerns were addressed more, when a caregiver simply sat down.

hcahps ratings

 

CLEAR EXPLANATIONS

In addition to courtesy and respect, provide your patients with clear explanations. Remember that the patient decides whether they understood an explanation clearly, not the provider. Minimize any confusing language, eliminate the jargon that would normally be used from caregiver to caregiver, and keep the conversation on their level. There are two main tactics that can be used to make sure that you’re explaining clearly:

  • Explain your care. Explain why you are performing any function, no matter how simple, whether it’s adjusting an IV or moving a call light closer: “It’s for safety…It’s for privacy…It’s for your comfort.” If the patient knows why you’re doing something, it makes a much bigger impact.
  • Listen to your patients’ responses. Listening to patients sounds like something that should be second nature, but it is imperative to make sure that patients feel listened to. This can be accomplished by employing a tactic known as active listening. Some examples of active listening include nodding your head when the patient is speaking, repeating small
    details, or asking for clarification on a certain point. These tactics communicate that you are interested and engaged in what the patient is saying.

If you employ one tactic to make sure your communication with patients is effective and showing up in HCAHPS ratings, it should be to remember courtesy and respect. Sit down when you’re in a room with a patient. Listen actively and use explanations that are free of medical jargon. These simple gestures make sure that patients know that they are important and that they are more than just a case number.




5 Areas of Focus for HCAHPS eBook