Government spends a lot to improve patient satisfaction scores, While the motivation may be partly
financial, the goal of improving the patient experience during emergency
department and hospital visits is an admirable one.
Unfortunately, many of the tactics used by administrators have done little to achieve that goal. Hiring national “experts” on customer service to give lectures to the hospital staff, or introducing catchy mnemonics like AIDET (which stands for Acknowledge, Introduce, Duration, Explanation, and Thank You) to guide physicians in conducting more compassionate patient interviews, have been equally ineffective in markedly improving patient satisfaction.
If we aim to better the patient experience in the hospital, we need to shift our focus from the patients to the nursing staff. After all, the people who spend the most time with patients are not the physicians but the nurses. If nurses are dissatisfied at work, patients will inevitably be dissatisfied with their experience.
Recent discoveries in the field of positive psychology have
demonstrated that being successful in any endeavor (including improving
patient satisfaction in emergency departments) requires happiness as a
prerequisite. If we truly want to improve the safety, care, and
experience of our patients, then we need happier people at work. In his
book, The Happiness Advantage, Shawn Achor highlights the link between
success and happiness. “Studies show that simply believing we can bring
about positive change in our lives increases motivation and job
performance; that success, in essence, becomes a self-fulfilling
prophecy.”
Ensuring we have happier nurses won’t just improve patient satisfaction; it will, more importantly, improve the safety and well being of anyone being treated in the emergency department. Happier people are more aware of their surroundings, they take more pride in their work, and they’re less likely to make mistakes. In the ER, this is imperative. A happier, more engaged nursing staff will be able to recognize red flags (including physician error), identify septic patients, and stay on top of their workload.
Ultimately, success in the emergency department means many things:
taking good care of patients, looking after their best interests, and
ensuring they do not have a life- or limb-threatening illness. Being
successful isn’t just about improving patient satisfaction scores. It
also means taking care of patient anxiety, treating their pain, and
making them comfortable. It means that nurses (and physicians) are in a
state of flow, can handle stress, and are aware, in the moment, and
conscious of what they’re doing. This will help them work better as a
team. Being happy at work also provides nurses with self-confidence and
self-esteem. “The more you believe in your own ability to succeed, the
more likely it is that you will.”
If our nursing staff is happy, they are likely to see working in the ER as a calling rather than a job. In other words, “people with a calling view work as an end in itself.” Achor makes a case that happy employees have different priorities beyond just earning a paycheck: “Their work is fulfilling not because of external rewards but because they feel it contributes to the greater good, draws on their personal strengths, and gives them meaning and purpose.”
When nurses view their work as a calling, they can see more clearly the benefits they provide to patients, such as alleviating pain and suffering, quelling anxiety, diagnosing illness, and providing compassionate care.
I recently became the director of the emergency department at Desert
Springs Hospital in Las Vegas. As soon as I took over the position, my
mind reeled with the changes I wanted to make to ensure that patients
were adequately taken care of, treated with respect, seen in a timely
manner, and that their pain, anxiety, and questions were addressed
quickly and effectively. I soon realized the most effective way to bring
about such changes is to make sure that the people spending the most
time with those patients — the nursing staff — are adequately taken care
of.
I’ve started asking nurses about their goals and frustrations. I don’t schedule meetings with a bunch of doctors to figure out how to best improve patient satisfaction, but rather I ask the nurses themselves, individually and in real time:
Unfortunately, many of the tactics used by administrators have done little to achieve that goal. Hiring national “experts” on customer service to give lectures to the hospital staff, or introducing catchy mnemonics like AIDET (which stands for Acknowledge, Introduce, Duration, Explanation, and Thank You) to guide physicians in conducting more compassionate patient interviews, have been equally ineffective in markedly improving patient satisfaction.
If we aim to better the patient experience in the hospital, we need to shift our focus from the patients to the nursing staff. After all, the people who spend the most time with patients are not the physicians but the nurses. If nurses are dissatisfied at work, patients will inevitably be dissatisfied with their experience.
Ensuring we have happier nurses won’t just improve patient satisfaction; it will, more importantly, improve the safety and well being of anyone being treated in the emergency department. Happier people are more aware of their surroundings, they take more pride in their work, and they’re less likely to make mistakes. In the ER, this is imperative. A happier, more engaged nursing staff will be able to recognize red flags (including physician error), identify septic patients, and stay on top of their workload.
If our nursing staff is happy, they are likely to see working in the ER as a calling rather than a job. In other words, “people with a calling view work as an end in itself.” Achor makes a case that happy employees have different priorities beyond just earning a paycheck: “Their work is fulfilling not because of external rewards but because they feel it contributes to the greater good, draws on their personal strengths, and gives them meaning and purpose.”
When nurses view their work as a calling, they can see more clearly the benefits they provide to patients, such as alleviating pain and suffering, quelling anxiety, diagnosing illness, and providing compassionate care.
I’ve started asking nurses about their goals and frustrations. I don’t schedule meetings with a bunch of doctors to figure out how to best improve patient satisfaction, but rather I ask the nurses themselves, individually and in real time:
- What is your overall satisfaction working at our hospital?
- What is the most stressful thing about your workday?
- What can we do to improve your workday?
- Do you feel rested? Do you have enough breaks?
- Do you enjoy working with your colleagues? Is there anyone here who drives you down?
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