Magazine article Health Facilities Management

A Nurse's Perspective: How HCAHPS Surveys Relate to Health Care's Mission

Magazine article Health Facilities Management

A Nurse's Perspective: How HCAHPS Surveys Relate to Health Care's Mission

Article excerpt

The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey is the first national, standardized, publicly reported survey of patients' perspectives of hospital care. HCAHPS scores are included among the measures to calculate value-based incentive payments in the hospital value-based purchasing program. The survey's goals include producing data about patients' perceptions of their care as well as creating new incentives for hospitals to improve quality care through public reporting.

To understand the nurse's perspective on improving the patient satisfaction scores that relate to the care of the environment, it is important for hospital environmental services (ES) professionals to be aware of the foundation from which the nursing delivery model of health care has been formed as well as the role that the environment has on the overall healing aspects of patient care. Understanding that cleanliness of the environment is a patient care function that originally was part of the nurse's role and now includes ES staff and infection control professionals will help collaboration efforts to improve patient satisfaction scores.

But the first and foremost goal of nurses isn't to increase a patient score related to perception. Instead, it is to provide the safest, best care possible for patients with the resources at hand. Once this has been accomplished, the nurses' second goal is to help the patients realize that the first goal has been met.

So, obviously, nurses cannot begin by reviewing HCAHPS scores nor develop strategies for changing how they provide patient care based solely on rankings and percentiles of patient perceptions. Instead, it begins with making sure they are providing the safest and best care for their patients and then using the patient perspective scores as one means among many to measure overall care when looking for improvement opportunities.

Back in time

What if ES professionals could forget for a moment the quest for achieving perfect HCAHPS scores, forget the pressure from administrators to achieve higher "top box" results on what may be a handful of patient comments, forget the push to create the "illusion of excellence" when given the resources for "status quo" and move back in time to when the foundation of the professionalism in nursing was born?

Tremendous changes have come to health care regarding the responsibilities placed upon the nursing staff. These changes have resulted in many duties that were once part of the professional nurse's role being delegated to staff, such as infection prevention and control, or to technical staff such as nursing assistants, patient transport and the ES staff. Even though these responsibilities are being shared with other members in the organization, they are still part of the overall patient care picture that is shared by the team, which is led by the registered nurse.

When it comes to environmental cleaning in patient care areas, it is impossible to separate the roles of nursing, infection prevention and control, and ES. All staff members are working together for the good of the patient and this area of their care requires the overlap of these specialists.

This overlap has evolved over the past 150 years. By the mid-1850s, the world of health care was no better than the centuries before. But in several parts of the world at nearly the same time, many changes and discoveries were taking place.

One of these places was in Europe. The Crimean War was raging and the human cost was immense. With a death toll estimate of 25,000 British, 100,000 French and up to a million Russians, almost all were caused by disease and deplorable care. In fact, the health care that anyone received was deplorable during those days and it was a well-known fact that the wealthy did not frequent the hospitals, only those too poor to pay for care in their homes would be found in such squalor. …

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