If you’re a nurse working in a hospital, chances are you’ve recently attended a customer service workshop. I just went to a program on AIDET as part of nursing orientation. A lot of what was talked about was not new:being respectful and attentive, giving clear and concise explanations and including the patient and family in the decision making process. What did surprise was when the instructor said that customer satisfaction scores are now being tied to federal funding.

That got me thinking. Up to now I’ve only been familiar with the Press Gaineys, a private survey firm. I’m sure your hospital has something similiar. Patients are selected to receive the survey after discharge and they rate the hospital, nurses, doctors and other services. It is hospital driven and customized to the institution. In 2005, however, the Centers for Medicare and Medicaid Services(CMS) came up with a standardized survey to track customer satisfaction, wordily called the Hospital Consumer Assessment of Health Providers and Systems. HCAHPS, or Hospital CAHPS, or the CAHPS hospital survey, is a voluntary survey. However, according to this article from the New York Sun, hospitals that don’t report their results can lose 2% of their inpatient Medicare funding. At this time, hospitals do not have to pay to participate.

CAHPS(with and without the first H) are funded and administered by the U.S. Agency for Healthcare Research and Quality(AHRQ). The CAHPS program was started almost a decade ago, so that a standardized system of patient surveys could be put into place to help improve patient centered care. There’s a CAHPS for dental plans and another to assess the health care experiences of Native Americans’ use of tribal clinics, among others. The survey results are part of the public domain and available online.

So why should any of this concern us as nurses? Besides the fact that it’s an hour of my life I’ll never have back again. I’ve heard much grumbling from the trenches about how this is just another ploy by the hospital to make money and make our jobs harder. What matters is delivering top-notch nursing care, not being warm and fuzzy. Nurses are a tough crowd with the best of topics, but try telling them that they’re not being nice enough and you’re liable to have a revolt on your hands.

Patient satisfaction is important(sorry, to me they’re still patients, not customers). My experiences as a transplant coordinator bear this out. As I’m sure you know, asking a family to donate their organs couldn’t happen at a worse time. Who wants to make such an important decision when dealing with the death of a loved one? Unfortunately, time is of the essence and we work in a small window of time to make the request, sometimes only a few hours. Gaining a family’s trust is tantamount. I’m not talking about putting one over on people. I’m saying that within the short time frame allowed, you have to not only help the family come to terms with brain death, you have to give them all the information they need to make an informed choice. This doesn’t just apply to life and death situations. Patient education and planning care are synonymous with nursing. Managed care means that many of our patients are only with us for a few days. In the ER or Same Day Surgery, a few hours. It should come as no surprise to anyone that increasing a patient’s satisfaction, increasing their trust and comfort levels, is going to enhance their learning and increase their desire to participate in the healthcare plan.

Hospitals love to have good survey results. They plaster them in the papers and work them into their advertising. So is all this good PR for the hospital? You bet. Should nurses be valued for their ability to start an IV as well as their winning smile? Absolutely. But the bottom line is that keeping patients happy can also be good for their health.