Patient Satisfaction Surveys: Safety Strategy or Popularity Contest? Op-Ed by Meg Helgert, FNP Originally published in Confident Voices eNewsletter-02/2011 I recently read an article published by Rice University School of Business (1) (which was devoted to businesses, but can be used in the health care setting as well), discussing how relevant "patient/customer satisfaction surveys" are and what (if anything) they disclose to non-medical administrators. The article questions the significance of these surveys in terms of patient safety and medical outcomes. Many of these surveys ask patients questions that have little or no bearing on care in terms of the outcome and their safety, primarily in hospitals. Yet patients answer these questions believing they know what outcomes should be, based solely on the hospital appearances, how good the food was, what color the walls are, or how many times the nurse smiled at them! (1) http://www.media.rice.edu/media/NewsBot.asp?MODE=VIEW&ID=15002&SnID=1658789314 Although this article looks at other business models, it can reflect on how major hospital corporations use these surveys to draw "customers" into hospitals. Administrators also use these as leverage to retaliate against employees, withhold raises, and even base decisions regarding staffing on these tools. I believe these surveys simply do not ask the right questions, nor do they obtain the information that would actually help the hospital in evaluating patient care. Since health care is now "big business" and thus is in the business of making money to satisfy corporate investors, how do health care providers -- nurses, physicians and all involved in care of patients -- respond to this corporate mindset? I believe health care will never be a business, in the truest sense of the word, such as Macy's or Starbucks, and that the success of health care should always be based on outcomes of the health care provided. However, this is difficult to measure at any level. Evidence- and community-based outcomes can help define quality of care by each health care board charged with ensuring quality of care and protection of the public. We have Boards of Medicine and Nursing that address these issues, we have Boards of Radiology Technology, Boards of Pharmacy, and a variety of boards that are the defining measure of each discipline, and yet these boards are not called upon to step in until there is a bad outcome. In a recent court decision, two nurses in a small West Texas town (Whistleblower) who turned in a physician for less than excellent care had to live through a lengthy trial in order to be acquitted. Now the physician and town sheriff are in court defending themselves, and the nurses are without jobs or the opportunity to find work because of this action. We read in this article how the physician is still practicing, and my guess is that this has to do with the money the hospital stands to lose in his absence. In this case, it is clear that the Boards of Nursing and Medicine were called in to help defend both the quality of care and to assess each nurse and physician involved in this case. The hospital chose to fire the nurses for the bad publicity they created and, most likely, loss of income to their hospital, which has nothing to do with patient care and outcomes. The headlines in this little country newspaper must have divided this town on both sides of this court case, yet I applaud the nurses for standing up for patient care. Unfortunately these headlines may follow them to other jobs. In closing, surveys are tools best used in department stores or grocery stores, not in the health care setting. These are far too dangerous to be used by non-medical personnel for adjusting staffing, declaring best-case outcomes, and building revenue. Health care is not a popularity contest. Health care is serious business, with very real outcomes that cannot begin to be adequately evaluated through use of "patient satisfaction surveys" or measured by appearances or food quality at the hospital. Meg Helgert RN, FNP-BC Send Meg an email if you'd like to comment or have an issue you'd like her to review!

Patient Satisfaction Surveys:

Safety Strategy or Popularity Contest?

Op-Ed by Meg Helgert, FNP

Originally published in Confident Voices eNewsletter-02/2011

I recently read an article published by Rice University School of Business (1) (which was devoted to businesses, but can be used in the health care setting as well), discussing how relevant "patient/customer satisfaction surveys" are and what (if anything) they disclose to non-medical administrators. The article questions the significance of these surveys in terms of patient safety and medical outcomes. Many of these surveys ask patients questions that have little or no bearing on care in terms of the outcome and their safety, primarily in hospitals. Yet patients answer these questions believing they know what outcomes should be, based solely on the hospital appearances, how good the food was, what color the walls are, or how many times the nurse smiled at them!

(1)

http://www.media.rice.edu/media/NewsBot.asp?MODE=VIEW&ID=15002&SnID=1658789314

Although this article looks at other business models, it can reflect on how major hospital corporations use these surveys to draw "customers" into hospitals. Administrators also use these as leverage to retaliate against employees, withhold raises, and even base decisions regarding staffing on these tools. I believe these surveys simply do not ask the right questions, nor do they obtain the information that would actually help the hospital in evaluating patient care.

Since health care is now "big business" and thus is in the business of making money to satisfy corporate investors, how do health care providers -- nurses, physicians and all involved in care of patients -- respond to this corporate mindset? I believe health care will never be a business, in the truest sense of the word, such as Macy's or Starbucks, and that the success of health care should always be based on outcomes of the health care provided.

However, this is difficult to measure at any level.

Evidence- and community-based outcomes can help define quality of care by each health care board charged with ensuring quality of care and protection of the public.

We have Boards of Medicine and Nursing that address these issues, we have Boards of Radiology Technology, Boards of Pharmacy, and a variety of boards that are the defining measure of each discipline, and yet these boards are not called upon to step in until there is a bad outcome.

In a recent court decision, two nurses in a small West Texas town (Whistleblower) who turned in a physician for less than excellent care had to live through a lengthy trial in order to be acquitted.

Now the physician and town sheriff are in court defending themselves, and the nurses are without jobs or the opportunity to find work because of this action. We read in this article how the physician is still practicing, and my guess is that this has to do with the money the hospital stands to lose in his absence.

In this case, it is clear that the Boards of Nursing and Medicine were called in to help defend both the quality of care and to assess each nurse and physician involved in this case. The hospital chose to fire the nurses for the bad publicity they created and, most likely, loss of income to their hospital, which has nothing to do with patient care and outcomes.

The headlines in this little country newspaper must have divided this town on both sides of this court case, yet I applaud the nurses for standing up for patient care. Unfortunately these headlines may follow them to other jobs.

In closing, surveys are tools best used in department stores or grocery stores, not in the health care setting. These are far too dangerous to be used by non-medical personnel for adjusting staffing, declaring best-case outcomes, and building revenue. Health care is not a popularity contest. Health care is serious business, with very real outcomes that cannot begin to be adequately evaluated through use of "patient satisfaction surveys" or measured by appearances or food quality at the hospital.

Meg Helgert RN, FNP-BC

Send Meg an email if you'd like to comment or have an issue you'd like her to review!