How Nursing Leadership Can Move Surveys from Usually to Always

As a nurse or nurse manager, you strive to provide safe care along with an excellent patient experience. If you have attained that goal, then you may have found your hospital in the upper 25th percentile of the national database. That’s an accomplishment, so congratulations – high fives all around. The problem is once you meet that milestone, how can nursing leadership continue to improve?

nursing leadership in busy hospital

Taking the next step means moving those patient survey responses from “Usually” to “Always”. The idea is to provide care that will encourage your patients to pick “Always” on the HCAHPS survey in every domain, presenting you with top marks for your care, but how?


Adding Definition to Your Strategies

Consistency is the key to quality care and improved scores on the HCAHPS survey. It seems to make sense to dedicate your department to a “flavor of the month” enhancement like patient safety, communication, and responsiveness, but are you consistent in the way you deliver them?

To provide care that will make an impact on your patients, nursing leadership must be consistent in practicing core principles such as safety, communication, and responsiveness. This means focusing on a few basic tactics, that can make an impact on both your patient’s experience and how they score you on the HCAHPS survey.

Bulking Up Your Score with Regular Rounding

There are two major tactics to factor in consistently to further enhance your nurse to patient communications skills. Start by initiating regular rounding or hourly rounding. This is good for many reasons, but, ultimately, it sets the patient’s expectations. They never feel deprived or alone when they know you, their nurse, are coming around in regular intervals.

From the nurse’s standpoint, if they know you are coming back on a schedule, it keeps your patient from getting up over and over without assistance. That’s a point for patient safety. For nurses, it adds certain efficiency to the work, as well.

Making Use of the Communication Boards

Another underused but highly effective communication tool is the communication boards. This is powerful and engaging information for the nurse, regular staff, and the patient. Communications boards clearly state:

  • Upcoming appointments
  • Medications
  • Nurse’s name

By keeping that information current, nurses reduce patient and family anxiety and foster effective communication all around.

Nursing Leadership Can Get Better Responses with Enhanced Responsiveness

Consider two tactics that work well in the domain of responsiveness:

  • The “Five Foot Rule” states that a nurse should never be more than five feet away from a call coming in at the nurses’ station. It’s a simple concept that ensures the patient never has to wait once that button is pushed.
  • Establish a department-wide policy that states no member of staff should walk by an engaged patient’s assistance light without checking to see what the patient needs.

Those two enhancements really focus the entire staff’s attention on responsiveness to the patient’s needs.

The trick is to learn to improve those scores by figuring out what works for you and your hospital. Ask the nursing managers to talk about enhancement tactics like the ones listed here during meetings. Bring them up any chance you get, really, maybe at larger group meetings, as well. Promote the idea of a skills lab that video tapes staff working with mock patients to see what works and what doesn’t and improve skill sets. Staff can provide feedback to promote consistent delivery.

Instead of just picking out new tactics with each patient or each shift, focus relentlessly on the basics listed here and soon you will find yourself moving up to the “Always” rank.5 Areas of Focus for HCAHPS eBook

1 reply
  1. Rae
    Rae says:

    To enhance the response and response time, hire more staff and ancillary staff. RN’s cant stay in a five foot radius. RN’s can’t stop at every call light they pass, when they can barely keep up with their patient load. Nice ideas but not realistic today.


Leave a Reply

Want to join the discussion?
Feel free to contribute!

Leave a Reply

Your email address will not be published. Required fields are marked *