Nurses have the most patient contact compared to any other profession in the healthcare system. As such, their approaches and their interaction with the patients greatly influence the overall experience of the patient’s hospital stay. This is objectively measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. The survey concludes that the patient’s overall experience drives a hefty 30% of the value-based purchasing (VBP) scores and incentive payments.
The survey is composed of 32 questions all gearing towards asking as to how often do specific incidences or behaviors happen within their hospital stay. These questions are grouped in dimensions, with each being scored individually. Currently, 8 domains are included in the survey for VBP scoring: communications with nurses, communication with doctors, hospital environment, responsiveness of hospital staff, pain management, communication about medicines, discharge information, and overall rating.
In a recent study in the nursing informatics field published in the Journal of Nursing Administration, the HCAHPS survey was used to formulate strategies in improving nurse engagements on their patients. Analysis of the results show that when nursing communication is improved, other aspects such as the responsiveness of the hospital staff, pain management, communication about medicine, and the overall rating.
It is believed that once the communication between nurses and patients are improved, then follows better patient care. According to the nurse informatics research, the highest degrees of engagement were in bedside nurses during their first 6 months of the job. The level significantly decreases after a year and does not go up substantially in 10 years. It was also found that nurses who have been promoted to administrative positions have more engaging attitudes towards the patients than those nurses who directly provide care in the bedside.
To be able to target engagement in the nursing practice, it is most helpful to identify the barriers to this factor. Several can be identified including education, culture, or issues within the operating unit. This can be breached by educating the nurses of the importance of improving the patient experience in their own ways. They need to understand that good nurse engagement practices will, in the long run, reduce readmissions and thereby decreasing overall costs of healthcare. Understanding the benefits of improving their performance will help them embrace the positive changes they have to implement in their practice.
A preceptor or a mentor is also important and may reduce the attrition rate of nurses from the profession. It has been shown that if a mentor is present to provide assistance and support, the nurse engagement and retention was greatly improved. Ownership of tasks and increased accountability given to direct care nurses also have a positive impact on nurse engagement and performance. This way, they would be able to look at tasks as their contribution to the team, not as much as yet another work to be done and over with. Recognition and appreciation of a job well done is the key to motivating, not only the awarded employee but also the other members of the team as well, to be more efficient and to love their work.
In order to improve the engagement factor in the healthcare system, everyone must be involved. Even small changes in ordinary practices may prove to be helpful in moving the patient experience up to a higher notch.