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Scrutinize those follow-up surveys
To compete in today’s health care market, hospitals and clinics need to be a cut above the competition. Therefore, administrators are placing much more emphasis on patient satisfaction to ensure patients will remain loyal customers. Many facilities hire national satisfaction measurement companies to determine how well they are doing compared to other facilities their size across the nation.
In the battle for customers, patient education plays a key role. As part of its marketing strategy, the Department of Veterans Affairs (VA) identified several customer service standards, and patient education is one. The patient-focused standard reads: "We will try to provide information and education about your health care that you will understand."
The VA conducts its own satisfaction measurement survey throughout the system and releases the results annually. "Looking at the 2000 survey scores, patient education correlates highly with overall patient satisfaction. We are really seeing the connection," says Carol Maller, RN, MS, CHES, patient education coordinator for the New Mexico VA Health Care System in Albuquerque.
To obtain the scores, patients randomly are given the customer satisfaction survey in both the inpatient and outpatient areas. Questions pertaining to patient education include: "Were you involved in decisions about your care as much as you wanted?" and "Did you get as much information about your condition and your treatment as you wanted from the provider?"
Patient education and patient satisfaction are integral, says Jackie A. Smith, PhD, project administrator and clinical associate professor at the University of Utah Health Sciences Center in Salt Lake City. Patient education compliance and customer satisfaction are based on whether patients’ learning needs are met, and that can be anything from a map to the hospital to detailed information about a restrictive diet.
Also, both depend on whether health care workers are kind, courteous, and available, and treat patients with respect and dignity. When patients are treated well, their ability to absorb the learning increases dramatically, explains Smith. "When you blend patient education and patient satisfaction together, you will have better outcomes in both," she says.
Good patient education has a great impact on patient satisfaction, says Yvonne Brookes, RN, patient education liaison for Baptist Health Systems of South Florida in Miami. It’s not enough to give people information; they must understand it. "If patients don’t have their basic questions answered because a health care worker is too busy, they will be dissatisfied," she says.
Failing to tailor education to the patient’s learning preference can cause dissatisfaction, says Pamela Moore, MSN, RN, vice president of nursing at Citrus Memorial Hospital in Inverness, FL. Also, patients who are dissatisfied with their care or have other problems such as financial worries are not as ready to receive the education. "They may not be as satisfied with the education because they aren’t as receptive at that point in time," she explains.
Discernment always is warranted due to outside factors that could influence numbers, such as dissatisfaction with the admitting clerk. However, patterns are revealing. To make sense of the data garnered from patient satisfaction surveys, the right question must be asked, says Brookes. "We need specific questions, clearly written to illicit the kind of outcome we want, not vague questions like Were the admitting clerks helpful?’ Open-ended questions are best because the patient can provide information that is really useful."
Although Baptist Health Systems uses a national satisfaction measurement company, a team is creating a section specific to patient education with permission from the company, which will have four or five questions about education, says Brookes. Some of the questions were too vague and others too negative. "One question asked about complications, and we didn’t want the question to be negative from the beginning. We wanted people to assume there wouldn’t be complications," says Brookes. That question was changed to: "Were you told what problems to watch for after you went home?"
At the VA in Albuquerque, surveys determined that patients were dissatisfied with education about medication side effects. Yet it did not pinpoint why patients weren’t satisfied. It could be because they were given too much information, the information is too sophisticated, they don’t know how to individualize it for their particular situation, or they want 24-hour access to side effect information, says Maller.
To determine what strategy to take to improve patient education in this area and therefore boost satisfaction scores, Maller plans to organize focus groups to determine why patients are confused. It’s best to implement one strategy at a time rather than six, so it is easy to determine whether the strategy worked, she advises.
Although written surveys frequently are used to measure patient satisfaction, follow-up phone calls to patients after discharge to ask if they have questions often is more useful, says Brookes. Where there is confusion, there is usually dissatisfaction with teaching, she explains. For example, a patient may not know how to take medications safely. Tracking this information might uncover patterns and areas for improvement.
To improve patient satisfaction, be proactive rather than reactive, says Smith. Rather than using data gathered after a program was implemented, gather data up front so the program will fit patients’ needs from the moment it is first implemented.
What is certain is that we are in an age where patients are bombarded with information about their health and they often get confused. It is up to the health care industry to take the lead by making patient education an important part of patient care. "People are satisfied when they feel they are in control, and knowledge puts people in control," says Brookes. (To see how one hospital improved patient satisfaction by giving patients more control through knowledge, see article, below.)
For more information on improving patient satisfaction with good patient education, contact:
• Yvonne Brookes, RN, Patient Education Liaison, Baptist Health Systems of South Florida, 6200 S.W. 73rd St. Miami, FL 33143. Telephone: (305) 242-3530. Fax: (305) 242-3578. E-mail: YvonneB@bhssf.org.
• Carol Maller, RN, MS, CHES, Patient Education Coordinator, New Mexico VA Health Care System, 1501 San Pedro Drive S.E., Albuquerque, NM 87108. Telephone: (505) 265-1711, ext. 4656. Fax: (505) 256-2870. E-mail: email@example.com.
• Pamela Moore, MSN, RN, Vice President of Nursing, Citrus Memorial Hospital, 502 Highland Blvd., Inverness, FL 34452. Telephone: (352) 344-6530.
• Jackie A. Smith, PhD, Project Administrator/Clinical Associate Professor, University of Utah Health Sciences Center, College of Nursing, 10 South 2000 E. Front, Room 332, Salt Lake City, UT 84112. Telephone: (801) 581-4804. Fax: (801) 581-4642. E-mail: Jackie.Smith@hsc.utah.edu.