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Compassionate Nursing Care Linked to Higher HCAHPS Scores

 |  By Alexandra Wilson Pecci  
   February 24, 2015

A framework for compassionately connecting with patients is likely to ease patients' suffering and to lift HCAHPS scores, clinical quality measures, and reimbursements.

Fifty-six seconds.

That's how long it takes to make a connection with a patient. It could be something as simple as asking about her family, whether she has any pets, or what she likes to do when she's not stuck in the hospital.

The patient might talk about just one thing during those 56 seconds, but anything she says can be built upon throughout the course of her hospital stay. As a result, she patient feels more in control, acknowledged, and is likely to give her healthcare provider more information, allowing for better care.


Christy Dempsey

HCAHPS scores, clinical quality measures, and reimbursements are likely to rise. All because of a 56-second effort to make a personal connection.

A report from consulting firm Press Ganey, "Compassionate Connected Care: A Care Model to Reduce Patient Suffering," details the firm's model for connecting with patients. First and foremost, connecting with patients and improving care requires acknowledging that patients are, indeed, suffering.

"We started talking about suffering a couple of years ago. The word suffering is emotional; it doesn't feel good, and certainly, as a nurse, it's a call to action," says Christy Dempsey, Press Ganey's CNO. "We needed to have an action to help our organizations to reduce suffering, and that's where Compassionate Connected Care came from. It's a framework to help to reduce suffering."

Although all healthcare providers should aim to provide this kind of care, nurses have always treated the whole person and provided holistic care.

"That's why I think this is really resonating with nursing leaders," Dempsey says.

The Compassionate Connected Care framework includes six main themes. Within those themes are actions that healthcare providers can implement immediately, and others that will take more time and effort.

But doing so pays off. Dempsey points to a nursing unit at one hospital in Missouri which saw its HCAHPS score rise from the 50% to 90% percentile after piloting some of these tenets.

"There are things in each one of these tenets that [providers] could do this afternoon that would improve the patient experience," Dempsey says. "There are things that you can do today and build from."

They are:

Acknowledge Suffering
"We have to acknowledge suffering and show our patients that we care," Dempsey says. Simply doing that can actually reduce the suffering all by itself, she adds.

Body Language Matters
Nurses and other providers should sit down and make eye contact with patients while they're talking with them. Dempsey says doing so makes the patient perceive the interaction as longer and more meaningful—even if it's not—than if the nurse stands in patient's doorway, for instance. That compassionate connection will have a ripple effect: For instance, call light frequency goes down and requests for pain meds go down. "It's actually going to save us time," Dempsey says.

Anxiety is Suffering
Dempsey says that hospitals and healthcare providers are actually "instilling anxiety" when they do things like make patients wait a long time to get pain medication or to see a provider in the ED. Because of this, improving patient flow is critical. "It's hard work," she says. "But we have to do it."

Coordinate Care
"There are so many touch points that a patient has to go through," Dempsey says. "For the patient, it seems like the left hand doesn't know what the right hand is doing." Simple things like a physician telling the patient that she has read the notes from the patient's nurse, talked with their physical therapist, or had a meeting with their oncologist lets the patient know that the people on the care team are actually talking to each other.

Caring Transcends Diagnosis
"Real caring goes beyond the diagnosis of the patient. The patient is not the gallbladder in 202. It's Mrs. Smith who misses her dog, has a family," Dempsey says. "We have to get back to taking care of the whole person, not just the reason that they're in the hospital."

Autonomy Reduces Suffering
When patients check into the hospital, their clothes are taken away and they're told when they can walk, eat, go to the bathroom and go home. "We take away all control," Dempsey says.

Therefore any control nurses and other healthcare providers can give back can feel hugely significant. For instance, nurses might ask patients which arm they'd like blood pressure taken on, what time they'd like to take a walk, and whether they'd like to turn left or right out of their room when they take that walk.

"I think nurses have so many competing priorities that it's very difficult to focus," says Dempsey. "What I see is a very task-driven approach to patient care. We've got to get past that because we will never achieve the kind of patient care we want to deliver… if we don't connect."

Alexandra Wilson Pecci is an editor for HealthLeaders.

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