Satisfaction surveys can improve patient safety
Patient satisfaction surveys often are thought of as a tool for more of the business side of healthcare than risk management, but they can be a useful way to help improve patient safety. What you find out about a patient's experience could reveal shortcomings that need to be corrected.
Satisfaction surveys already might address issues that directly affect patient safety, such as communication with the patient, explains Ann Whitehead, JD, RN, vice president of risk management and patient safety for the Cooperative of American Physicians (CAP) in Los Angeles.
"The information you glean from a patient satisfaction survey, if the questions are worded carefully, can tell you about more than just customer service issues," she says. "If they are unsatisfied with some type of communication by physicians or nurses, that is a warning sign for safety. If the patient does not feel that the communication back and forth is adequate, that can lead to a number of errors and quality issues."
Whitehead offers this example of how a survey question can reveal potential patient safety issues: The patient is asked to agree or disagree with the following statement: "The nurse asked me to talk about my current health concerns."
"The person who is asking the question needs to elicit from the patient what is going on in order to provide the proper care, and that requires asking the patient to talk about the situation rather than just looking at the complaint on the chart and proceeding," Whitehead says. "Mistakes can be made, or you can have a mistaken impression of what the patient's problem is. You certainly get customer service information from that response, but a low score can indicate that your clinicians are not taking the time to listen to patients."
Other questions could hit on issues such as documentation and discharge. Responses could indicate that patients found discrepancies in what they told the doctor or nurse versus what was recorded. Or patients might report that they were sent home without adequate explanation of their medications or follow-up needs. All should be red flags for a risk manager, Whitehead says.
Whitehead cautions that risk managers cannot depend solely on complaints or threats to sue. The fact that patients do not complain does not necessarily mean they are satisfied with the care they are receiving, she says. The best survey questions elicit information from the patient about real events that transpire between the physician, staff, and the patient during treatment encounters or hospital stays.
Chances are good that the information useful to a risk manager already is being collected in the hospital's patient satisfaction surveys, Whitehead says. "What's important for the risk manager is to get involved in the process," she says. "Get the information from the surveys and find the questions that could have an impact on patient safety, then request the data so you can dig deep. Find the person who calculates all the information from the patient satisfaction survey and let that person know you are eager to hear of any results that could affect patient safety and quality."
It also is possible to add questions to the survey that are tailored specifically for risk management concerns, Whitehead says.
"In most cases, the information is already there in your facility somewhere, and you just need to find it," she says. "More data is always good when it comes to improving patient safety, so don't overlook what's already available to you."