Archive for the 'Learning' Category

MORE Skills for a New Economy: A Message to All Employees

March 2, 2011

(Part Two of Two)

In Part One, we discussed the need for employees to take ownership of their roles and the organization’s mission for all to gain sustainable excellence in the challenging times ahead. We explored ways employees at all levels can show their value across the organization and own their own development.

Here are a few more tips for leaders to share with staff members as they strive to become more valuable (and valued) in today’s tough new economy:

Understand the Connection between Time and Money.

Think about ways to be more effective and help others. When building a budget, consider all factors—including salary (often the biggest expense in a project) and time to complete. Be aware that as a project drags past its deadline, the chance it will go over budget increases.

Here are a few ways to be a good steward of your organization’s resources:

  • Get in the habit of quantifying. Avoid words like “a lot” and other generalizations. Get very specific and require others to do the same. Countless hours (and endless money) can be spent on activities because of reports that there were “a lot” of requests. When we take time to quantify the requests, we often find that “a lot” really means just a few people.
  • Keep things simple. When projects get too complicated, they either don’t get completed, or they result in considerable overruns on budget and missed deadlines.
  • Get the to-do list reviewed regularly. Focus on tasks that connect to the organization’s business goals; reduce the busywork.
  • Get timelines, a deliverables schedule, and a budget on everything you do. This is step one on any project. Creating a framework in the beginning forces an employee to think things through and often eliminates READY, FIRE, AIM problems. Report back regularly as to whether the project is on time and on budget.
  • Learn to ask, “How will we measure results?” Asking this question in the beginning allows us to really evaluate whether the project is worthwhile. It keeps employees from starting dead-end projects with no value…and allows us to showcase successful projects for a nice win.
  • Don’t confuse activity with progress. Focus on what matters. Twenty percent of the work creates 80 percent of the results. Can you move that number?
  • Give regular updates on ongoing projects. Something may have changed, or someone may have a new idea to make it better. Be proactive to stay on course.
  • Review processes regularly to make sure they don’t need updating. Continue to re-evaluate the way things are done and search for improvements. Don’t fall into habits.
  • Ask, “Is there something I do that could be outsourced?” An employee should let leadership know if there is a part of his or her job that the company could do more quickly, more efficiently, or less expensively by outsourcing. In the long run, an employee who thinks like this will show more value to the organization and will soon be on his or her way to bigger and better things.
  • Learn to put the well-being of your team over your own comfort. Think, If it were my money on the line, my future at stake, what would I do?

Remember, Communication Is Everything!

Work to create an infrastructure whereby information can flow. Then, do everything possible to help effectively move that information through the process.

Here’s how:

  • Communicate early and often. It will increase the odds of success exponentially.
  • Be more than an e-mailer. Sometimes it’s best to pick up the phone. It builds relationships. Plus, real conversations spark new ideas, and too much back and forth over e-mail may slow down the process.
  • Share information anytime you can. Ask yourself, What do I know and who else can benefit from it?
  • Think strategically about your e-mail CC line. There’s a delicate balance between keeping busy people in the loop and overwhelming them with too much (unnecessary) information. When copying someone on an email, be sure to let the recipient know what is expected. 
  • Reach out to others. Set aside a few minutes each week to reach out to people you don’t see that often. It creates goodwill and is the first step in collaborating in a meaningful way.
  • When asking for help, give a timeline. It helps busy people know how to sequence their projects.
  • Be clear. It eases anxiety. Before hitting “send” on an e-mail correspondence, review the note to make sure all the questions are answered and there is clarity in the letter.
  • Report the good and the bad. We can learn so much from mistakes. Mistakes help pinpoint areas where we need to get better and create an internal sense of urgency.

Tough times are ahead, and we need to be owners of ourselves and our organization, not renters. Show value. Actively seek personal development opportunities. Maximize profitability. Communicate. Standards have never been higher—and more public—so now is the time for employees to strive for excellence at every level, every time.

Skills for a New Economy: A Message to All Employees

February 23, 2011

(Part One of Two)

We are living and working in tough times. The healthcare industry is changing, budgets are shrinking, and a national emphasis on quality means our outcomes need to keep getting better and better.

Even organizations with a strong culture and talented employees can’t afford to relax. There is an unprecedented need for excellence at every level, every time.

What does that mean for individuals? It means every employee needs to consistently show his or her value—to bosses, to coworkers, and to patients.

Here’s the message leaders need to convey to staff members: To gain the sustainable excellence we’ll need to meet the challenges that lie ahead, we all need to take ownership of our individual roles and our organization’s mission.

So how can an employee show value and do his or her best possible work every time? Here are a few insights and suggestions to share with staff:

Hone Your Ability to Transfer Your Value across the Organization.

As the external environment gets more complex, an individual’s ability to survive and succeed is directly related to the ability to connect the dots, show insight, and communicate well with others. It’s important to show value to peers and leaders, inside and outside of your department.

Here’s how:

  • Understand the group you support. Know your audience. It’s important that we all learn to manage our time with consideration to the time of those we work with.
  • Have a nose for money and opportunity. Be efficient. Look for opportunities and be known as a problem solver inside the company.
  • Periodically attend other department meetings. It’s amazing how a different perspective changes the way we view things. Not only does this help us understand how what we do affects others, a fresh pair of problem-solving eyes in the group may help resolve the problem.
  • Offer insight. Be an active participant and share key learnings with those not in the meeting.
  • Connect what you do to revenue. While it isn’t possible to do with every job, most positions do connect to revenue directly or indirectly. Understanding this and being able to articulate it can help show value.
  • Understand the external environment and the need for a culture of always. Knowing the state of our industry, it’s important to create a culture of always that constantly implements best practices—every time, on every occasion, without exception.
  • Step outside your comfort zone. Sometimes people are too close to a challenge to see a solution. A fresh perspective—yours—can help others in the organization “connect the dots” in a new way. Being willing to boldly offer insights from an “outsider” point of view is a great way to show individual value.

Own Your Professional Development.

When we make a conscious effort to learn new things, professional development happens organically. Seek out structured professional development and training while keeping in mind that some of the most effective growth happens in day-to-day interactions.

Here’s how to make it happen:

  • Evaluate your personal brand. Do you like what you see? If not, it’s time to make adjustments. If you do, it’s time to take your personal brand to the next level. It’s important for employees to be self-aware and to get their unique talents out there.
  • Search out best practices and use them. Studer Group has spent years inside our National Learning Lab of nearly 800 healthcare organizations researching, harvesting, and refining the best ideas for maximizing human potential. Become familiar with the theories and enable them to work.
  • Take constructive criticism well. Honest feedback is a critical part of professional development. Think carefully about how to respond when feedback that is less than positive comes in.
  • Duplicate yourself. Mentor and teach whenever possible. Not only is it good for the organization (it frees you up for other things), it is incredibly rewarding.

The tips noted here focus on an individual’s personal value, brand, and development. In Skills for a New Economy, Part Two, we will focus on how each employee can take these skills to the whole company through maximizing profitability and communication.

Sincerely,

Quint Studer

Quint Studer, CEO
Studer Group
http://www.studergroup.com/

How Much Evidence Is Enough?

February 11, 2011

If it doesn’t directly impact clinical care, is it still worth doing? That’s the question I was recently asked while speaking to a physician group.

(Before I go any further, let me say that I welcome having my beliefs questioned. It’s one of the benefits of being able to travel all around the country and interact with so many wonderful people. I have many opportunities to learn and to become better.)

Anyway, a physician in the room stated that he did not believe the patient satisfaction survey was of much value due to the fact that it does not impact clinical outcomes. He also felt that a patient could be very satisfied, yet not receive good clinical care.

Let me address the second comment first. I agree. It is possible for patients to rate their care high in a survey and still not receive great clinical care. This is where an organization’s values come in. I don’t know of any organization that feels good if patient satisfaction is high and quality is not.

The inverse is also true. Many times an organization’s clinical quality can be excellent but other issues can lead patients to feel they did not receive excellent clinical care.

My comment the other day to a group of physicians in an academic medical center was, “Let’s have the patient’s perception of care match the clinical quality you are providing.”

Now, let’s go back to the challenge that started this blog entry: My first attempt to link the survey to the issue of clinical care was to read the questions. How well was your pain managed? How well were your needs responded to? How well were your questions answered? How well were things explained to you? How well were your home care instructions explained? I explained that I feel each of these can impact clinical care.

The physician disagreed, stating that these issues still may not change the clinical outcome. I then said, “So if a patient’s clinical outcome will not be impacted, then you don’t want your patient’s pain managed? Nor call lights answered?” The physician answered that of course he would want these steps to be taken.

That’s when it hit me. While I can connect the dots and also show more research that indicates a connection between patient satisfaction and clinical outcomes, the evidence really isn’t the point. There are times when even if actions do not impact the clinical outcome, certain behaviors and actions still need to be done.

Hospice caregivers do great work. Do their efforts change the clinical outcome? My first grandchild was stillborn. While the care and support given to my son and daughter-in-law did not change the clinical outcome, were they worthwhile? Yes, without a doubt.

Why do some people fight making some basic changes? I can’t take inventory for others, but based on years of experience, I do have some observations of my own.

For some people, it has to do with not being comfortable. If I am asked to do something that I am not comfortable doing and can come up with a reason not to do it, I have found a way to stay in my comfort zone. For others, I believe it is the fear of failure. They would rather not try at all than try and fail. I believe this is one reason best practices are hard to transfer in healthcare.

Some people may feel they are the voice for others. Have you ever noticed when someone is pushing back, he or she may often say, “Everyone,” “Most people,” or “Others,” rather than coming out and saying, “Here is how I feel.” Still others may feel they need more data before they can make a change.

It’s that last group of people, the data-seekers, who bring me back to the point. How much evidence is enough to make a change worthwhile?

I have come to this conclusion: There are times in life when we do the behavior even though there is not overwhelming research data to support it. We do it because it is the right thing to do. I can think of no reason more powerful than that one.

Sincerely,

Quint Studer

Quint Studer, CEO
Studer Group
http://www.studergroup.com/

Eight Roadblocks to Moving Best Practices

January 20, 2010

Have you ever noticed certain leaders or departments in your organization are really, really good at doing one specific thing? Maybe they consistently get great patient satisfaction scores, or their employees have very low levels of absenteeism, or their infection levels are consistently lower than those of similar areas.


It’s clear that these high performers are doing something different, something that sets them apart. And whatever “magic touch” they have, you’d love to bottle it and distribute it to other areas of your organization. In fact, you may have done some digging and figured out what they’re doing right. But when you tried to get others to follow their lead, there’s a good chance you fell short of the goal.


Harvesting “best practices” and transferring them to other leaders and departments is a wonderful way to achieve organizational consistency. And yet, many organizations just can’t seem to get it done. Have you ever wondered why?


We have discovered there are eight common “roadblocks” that keep organizations from identifying and moving best practices. They are:



  1. High performers can be modest. They minimize what they do. “Oh, it’s no big deal,” they’ll say. To figure out what they’re doing that’s different, you need to dig deep. In fact, digging deep with a high performer is how we initially discovered the impact of hourly rounding—which was later found to reduce call lights, falls, and skin breakdowns and to increase patient satisfaction.

  2. A leader may fear losing his edge. If he tells everyone about his best practice, he will be unable to keep up his success. This does not happen frequently, but it does come up.

  3. Sometimes the high-performing leader balks at taking on a “teaching role.” Maybe she doesn’t want others in the organization to think she is showing off or that she is the boss’s favorite. And when she does present, she will even give reasons for why she could successfully implement the best practice but it may be hard for others.

  4. Success is attributed to the leader and not the best practice. People think it’s the leadership and not the practice itself that’s getting the great results—so the actual best practice is missed or underestimated.

  5. Leaders want to keep their autonomy. Implementing someone else’s way of doing something makes them feel they are giving it up. It moves them out of their comfort zone. (This is especially true in the C-suite.)

  6. “Terminal uniqueness” can hamper moving best practices. Leaders are quick to point out how they are just a little bit different and that’s why a certain best practice won’t work for them.

  7. Egos get in the way. By the time some people get to the C-suite, they are better leaders than followers. Or at least they think they are!

  8. There is too much change and not enough time. There simply isn’t enough time for a best practice to be mastered—and it’s dropped before it’s given a fair chance.

The good news, of course, is that there are solutions to all of these roadblocks. Smart organizations will work to overcome them. Best practices are the ticket to great results—and isn’t that what we’re all looking for?


Sincerely,


Quint Studer


Quint Studer, CEO

Studer Group

http://www.studergroup.com/








Please feel free to share this blog with others by forwarding as an email or printing.

Emergency Room Nurses Have the Best Stories

October 8, 2009

It’s true. If you ever want to laugh until you cry ask an ER nurse to tell you a story. If you ever want to be stopped in your tracks with your eyes welling up with tears ask an ER nurse to tell you a story. I worked as an ER nurse for awhile, as did my wife, so I have a great love and admiration for what ER nurses do.

We’re coming up on ER Nurse’s Day (October 14th) so I have been thinking a lot about ER nurses and their stories. Isn’t it amazing how stories, in general, can move us? If you think about it stories are how we learn. Probably your favorite teachers were those that told great stories and didn’t just read from a book.

What can we learn from ER nurse’s stories? First of all we can learn that within those stories there is much inspiration. I spend a lot of time encouraging people in healthcare to share their stories as I speak around the country and I talk about stories a lot in my book Inspired Nurse as well as in my blogs and on the Inspired Nurse Facebook page. I do this because I have learned the power of our stories. They connect us back to who we are, where we’ve come from and what we are “made of” as nurses.

So…how can we make the best use of the amazing stories that live in our ER? Wouldn’t it be amazing to have a few of the ER nurses in your organization write their stories, their greatest moments in the ER and perhaps even their funniest ones? After they’ve done this perhaps post them in your newsletter, highlight them at a celebration, have them read these stories at a board meeting or even post them in the ER for all to see? Why? Because these stories will inspire. They will remind us why we do what we do. They will bring us back to the foundation of what we are as nurses.

As I always say when I speak at hospitals across the country, our stories are our “bricks.” They are what built us. Often, we don’t focus on these “greatest moment stories” though do we? Usually we tend to share more of the most recent and negative stories. After awhile, it seems as if those inspirational moments are few and far between. But they’re not. It’s just a matter of focus and attention. When you focus your attention on the negative, well, that becomes our perceived reality. Maybe it’s time we focus on some of the other stories?

So, dust off those amazing ER stories. Find some creative ways to get them out there and share them with your team. It’s often said that great organizations are known by the stories that they tell. So are great ER Nurses. Honor your ER nurses this year by laughing and crying along with their stories. I promise you two things about those ER stories. They’re never boring and they’re always inspirational.

One more tip. If you are a senior leader, another great way to honor your ER nurses would be to make rounds in the ER on ER Nurse’s Day to thank the nursing staff for the great work they do every day.

Be Well. Stay Inspired.

Rich Bluni, RN

Rich Bluni, RN, Studer Group National Speaker


If you are looking for ways to celebrate this special day, seats are still available for the Nuts and Bolts of Service and Operational Excellence in the Emergency Department on October 14 – 15, in Phoenix, Arizona. You may also consider presenting staff a copy of Inspired Nurse by Rich Bluni or Excellence in the Emergency Department, which was just published by Studer Group coach Stephanie Baker.

Do We Change Goals or Change Actions?

September 8, 2009

I was reading a story in a book about a person who turned his life around. One sentence just jumped out at me. The person said he used to reduce his goals to fit his behavior. His life turned around when he changed his behavior to fit his goals.

Right away I thought of healthcare. Over the years I have met thousands of people in healthcare, been in hundreds of organizations, and spent countless hours with senior leadership teams. I reflected on what I had read; do we change the goal or the performance? To me, this is one of the key characteristics that separates high performing organizations and individuals from those that are not high performing.

High performing organizations do not lower the goal; they increase their performance. They understand this will mean changing actions (behavior).

Other organizations spend their time discussing why they are different and lowering goals to fit their performance.

Which type of organization do you work for? What do you do? Do you change the goal or change your behavior?

I found these to be real gut check questions.

Announcing the Largest Ever Study on Health Care Leadership Skills

March 25, 2009

I’m writing to ask for your participation in an important research project within the healthcare industry. We anticipate that the findings of this study will impact how we train future health care leaders, just as the previous studies you helped us with proved the dramatic benefits of hourly rounding, identified characteristics of high performing organizations and shed light on issues of work-life blend among women in healthcare.

We are conducting what we hope will be the largest study ever of health care leadership skills. Our goal is to ensure that the next generation of leaders has the skills required to make healthcare even better. Conducted in partnership with The George Washington University, this study seeks to better understand the skills you had as an early careerist, the skills you think are most important for new leaders to possess and skills you believe will be needed in the future.

If you hold a leadership, management, or supervisory position in healthcare organizations, I invite you and/or your colleagues to take part in this study to create recommendations for actions and policies to enhance the skill sets of new healthcare leaders.

Go to www.studergroup.com/leadership and complete the survey by April 10th. The fifteen minutes of your time needed to complete the survey will impact the future of healthcare. We commit to sharing the results broadly and free of charge this summer.

The knowledge gained from the study will help schools and employers better train and retain healthcare leaders, two critical steps toward creating better places to work, practice medicine and receive care.

Every day we all have the ability to make a difference. Here’s an opportunity that will only take you 15 minutes today for results that will last generations.

Yours in service,

Quint

What’s Right in Health Care Conference and HCAHPS

May 20, 2008

Is there a day on the calendar that you look forward to every year as it gets closer? Maybe it’s a birthday. Maybe an annual reunion with old friends. As the date gets closer, your anticipation builds because you will be able to celebrate something important to you with people you care about. For me, one of my favorite days on the 2008 calendar is just five weeks away, so I’m feeling that same sense of excitement. Why? Because on June 18-20 I get to meet with and learn from the largest and most passionate group of healthcare leaders in the world, all in one place.

Our registration already includes more than 1,300 individuals from around the world committed to passionately implementing the same set of evidence-based tactics proven to save lives; to make healthcare better for employees; and to reinvigorate physicians in the practice of medicine the way it was intended. If you count yourself among the leaders committed to making healthcare better, I hope you are able to join us and experience the excitement and learning that takes place each year.

Over the three days we will be together, we will hear stories of what’s working well in healthcare organizations across the world, and leave with practical ideas we can put into action when we return back to our own organizations. While all three days will be solid with content, let me focus on just one of the educational sessions.

On Wednesday June 18th from 3:00-5:15, one of the six breakout sessions at that time will focus on HCAHPS. This intensive workshop is being led by two of our most senior coaches, who have worked with organizations in the HCAHPS pilot project, as well as a leader from Hackensack University Medical Center in New Jersey, one of the best performing organizations nationwide according to the initial HCAHPS results. Between their direct experience, and that of the organizations we have coached, Studer Group has more experience improving performance on HCAHPS than just about anyone else. In fact, whether you look at likelihood to recommend or a specific measure like pain control, 3 out of 4 Studer Group partners outperform the national HCAHPS database.

Why is this session important? Because HCAHPS is arguably the most powerful transformation for U.S. healthcare since President Lyndon Johnson signed Medicare and Medicaid into law as part of his “Great Society” plan in 1965. That’s a bold statement. But I believe it is also a fact, because for the first time since we, the people, were given these essential insurance plans, our voice now counts. As part of CMS’s ever-evolving Value Based Purchasing plan, the voice of the patient is now being heard through HCAHPS, and will soon help steer payments toward those providers whose customers perceive that they provide better care. As such it is absolutely critical that your organization understand and focus on the underlying issues that will shape the perception of your organization in the eyes of the patients for which you care.

Whether you plan to attend the HCAHPS breakout session or not, we strongly encourage you to take a moment and complete the following brief online survey. This three-part survey asks you to complete the HCAHPS questions just as a patient would; to list the single most important tactic that could improve the scores you gave; and any one question you would like the presenters of this session to answer. This anonymous survey results will be used in the actual presentation and will help customize the content to information you value. For your voice to be included in this survey, please click the following link before next Friday, May 23:

http://www.zoomerang.com/Survey/?p=WEB227SD2CAL42

This is just one of the 33 breakout sessions offered during the event. The other 32 breakouts each address a specific tactic, such as physician communication, service recovery, developing nurse leaders, rounding on employees, employee selection and retention, pain management, interdepartmental surveys, etc. Presenting organizations include winners of the Malcolm Baldrige National Quality Award, large academic medical centers and small hospitals serving rural America. In addition, we have 6 hours of plenary keynote sessions that will leave you talking; an awards event to celebrate together our shared successes in improving healthcare; and the world’s first concert specifically designed for healthcare leaders.

On June 18-20 I hope you will be able to join with hundreds and hundreds of leaders just like you – committed to making a difference. I hope to see you there.

Quint

Work-Life Blend Among Women Employed in the Healthcare Industry

March 4, 2008

As I travel the country and meet women who work in healthcare, the ever-increasing demands that women have in both their personal and professional lives is apparent. There are 10.7 million females employed in the healthcare industry. These women are making a difference at work, at home, and in the community. They shoulder tremendous responsibilities. It is time to better understand the unique and delicate issues of professional/personal blend facing the women who work in healthcare.

I invite you and/or your female colleagues to take part in a groundbreaking study to find solutions to work/life blend among women employed within the healthcare industry.

  • Go to www.studergroup.com/womensstudy and complete the survey.
    The fifteen minutes of your time needed to complete the survey will impact the future of healthcare.

The knowledge gained from the study will uncover new and different opportunities that employers can execute for greater recruitment and retention of female employees. This will enhance the work life environment for women and, through an enhanced work environment, we will produce improved patient care.

Every day we all have the ability to make a difference. This is an opportunity to directly touch the lives of the women you work side by side with. Again, I ask you and/or your female coworkers to be a part of developing solutions regarding the importance of females in healthcare.

HCAHPS

November 19, 2007

This past week Results That Last reached number 12 on the Wall Street Journal’s Business Best Sellers List. This means that when many non-health care leaders are reading Results That Last, they are seeing that there is much to be learned from leaders in health care. We have learned a lot from non-health care leaders—it’s nice to see it works the other way also. To those who have purchased Results That Last and given it to leaders you know, thank you.

This week’s blog is on HCAHPS. This is another opportunity to use transparency to show others the best of health care. Studer Group had the first Toolkit on HCAHPS. We have just released the third edition. Karen Cook is one of our experts in HCAHPS. She has over twenty-five years of nursing experience and was one of our first Studer Group employees. She and her partners have been working with the HCAHPS tool since the very early pilot stages in 2005. She has put together this blog on HCAHPS as well as a Webinar and the third edition of the Toolkit. Known for her passion in focusing on the patient, you will see in this blog that it is about “always.”


Usually isn’t good enough

Early in my 26 years of marriage I received some advice to “never go to bed mad.” I even have a picture that serves as a visual reminder of that great advice—it says ” Always remember to kiss me goodnight.” But how often do I do it? I can honestly say that I usually do; but usually isn’t good enough. I invite you to think about a similar setting in your everyday life. For example, can you honestly say you brush your teeth every night?

“Always” is an interesting word—defined by Webster’s dictionary as “at all times.” This is a high standard to attain, yet that is exactly how we want the patients to view their hospital care. With the new Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey tool, the patients are asked to rate their hospital experience. Measured in frequencies, patients will be asked about their perception regarding how often they received particular aspects of care. Hardwiring processes to “always” deliver quality care means providing the best care to every patient, every time and with every interaction. Usually isn’t good enough.

Previously sheltered from public reporting of clinical quality data, hospitals have entered a new era of transparency. As part of a larger movement to help inform consumers, the patient perception of their experience with a hospital will now be reported with other quality metrics. The tool is a standardized, national patient survey, allowing public sharing of comparable data across acute care hospitals. While many facilities have been interested in their patient’s perception of care for a very long time, I have found that the potential for public reporting is a very powerful motivator to become even better.

In our national lab of more than 500 hospitals, executives are asking “how can we prepare for public reporting of the HCAHPS survey results?” Studer Group has created two new tools to help hospitals achieve their desired outcomes in clinical, operational and service excellence. Aligned to the survey questions, both the HCAHPS Webinar and a new Toolkit are available now. Here are a few tactics described in these new offerings.

Key Words at Key Times
The survey questions focus on communication with doctors and nurses, responsiveness of staff, cleanliness and quietness of the environment, pain control, discharge information, and communication about medications. One of the most challenging questions on the HCAHPS survey asks the patient how often “did the staff describe medication side effects in a way you could understand?” We’ve seen several organizations improve their results just by incorporating key words to directly address this question. For example, when administering a pain medication, a nurse would commonly have said “this medication will help manage your pain but you might have some nausea – make sure and let me know if you do.” When the nurse adds the key words, “this is a common side effect,” this connects the dots for the patients and helps keep them fully informed. To verify this occurs with every patient, the nurse manager can ask the patient on rounds, “have your nurses explained your medications and helped you understand any side effects to look out for?” When the patient is preparing for discharge, the nurses can ask open-ended questions for patients to review their medications and any potential side effects. Key words are important to deliver a consistent message and keep patients informed, and they play a vital role in impacting this particular question and the medication reconciliation process. They should be integrated into daily care conversations in multiple avenues and not just when the medication is actually being given.

AIDET
The new HCAHPS survey asks the patients about how often the staff explained things in ways they can understand and how often they were treated with courtesy and respect. Our AIDET communication format is a great tactic to implement immediately to impact our communication with patients. Evidence shows us that if every employee would focus on Acknowledging patients, Introducing themselves and the anticipated Duration, Explaining things in ways patients can understand, and Thanking the patients, it would help reduce patient anxiety. To close the interaction, each staff member can ask the patient, “do you have any questions I can answer before I leave?” This will help impact the patient perception of listening carefully and explaining things in ways they can understand.

While we want to achieve excellent results on the patient perception of care survey, I think it is sometimes easy to lose sight of why we’re doing this. It is not about looking good on the survey. It’s about always providing the best care to our patients. This survey tool allows us to know what patients think about the elements of care that are most important to them and helps us understand if they would recommend our hospital to their family and friends.

If that is not motivation enough, the Centers for Medicare and Medicare Services (CMS) issued a final rule for hospitals paid under the Inpatient Prospective Payment System. Those hospitals eligible for the annual payment update must submit their HCAHPS data or forfeit 2% of the annual payment update. This is part of the quality measures required in the Reporting Hospital Quality Data for Annual Payment Update (RHQDAPU) and is required as of July, 2007. The financial penalty varies from hospital to hospital, based on a number of factors including average daily census, but could be substantial. This requirement puts in motion the pay-for-participation concept and there seems to be a clear movement to eventually tie reimbursement to performance on quality metrics, including the patient perception of quality.

The HCAHPS toolkit provides more than 40 ideas to impact these questions. The ideas have been generated from hospitals already focusing on improving their patient, physician and employee loyalty. In the era of public reporting, this strategy takes on a whole new meaning and is key to long-term success. As leaders, we have the exciting opportunity to guide our organizations to a culture of “always.” Easier said than done, a culture of “usually” isn’t good enough.