Skip to main content

5 Ways to Raise HCAHPS Scores via Staff Engagement

 |  By Chelsea Rice  
   January 28, 2013

Value-based purchasing and Hospital Consumer Assessment of Healthcare Providers and Systems survey scores have transformed patient satisfaction from a branding tag line to a financial incentive.

More than half (54%) of healthcare executives say patient experience and satisfaction is one of their top three priorities, according to HealthLeaders Media's 2013 Industry Survey data.

With patient volumes up as a result of healthcare reform, providers have less time to make positive impressions during their interactions with patients. That's why it's important to engage staff around delivering patient-centered care.  After all, those scores are largely based on the quality of the interactions—large and small—between patients and hospital employees.

But it may be tough to rally staff members who may be struggling with managing their own health and fatigue.

The key is for human resources leaders to translate patient-centered care from a strategic  executive-level priority into a cultural foundation of their organization.

Take 66% OFF the Patient Experience Collection
Package includes HealthLeaders Intelligence Report, book, Rounds, and webcasts on patient satisfaction, HCAHPS and more.

1. Establish early expectations
A strong value-based culture at any organization depends on expectations being set from the very start. Although cultures can be built, starting with an employee population that doesn't share the values or priorities of the organization creates an uphill battle. Human resource leaders and hiring managers should establish patient-centered care as a priority in the job description, as with all of the organization's cultural values.

Mary Ellen McCartney, chief learning officer at Gundersen Lutheran Health System, in La Crosse, WI, explains human resources' role in improving patient satisfaction scores at their organization this way: "What's important here is that we're hard wired all around for patient experience, so just because you change a patient satisfaction survey it doesn't mean we necessarily need a whole new communication approach."

"Through our human resource practices, we are hiring people that want to meet the patient needs. When you do that on the front end, and you set expectations and evaluate them based on those expectations, you basically embed any changes in the delivery model through that work."


2. Contract around the culture
Establish the values and culture of your organization within the job description itself. The HR department at Gundersen Lutheran evaluates potential employees with a "Fit Tool," which gauges a small set of values. Questions focus on determining an employee's "fit" with the system.

These questions are directed at determining an employee's response to certain situations, as well as to how they set goals and standards for themselves that might correlate with building patient-centered care on their unit or team, says McCartney. At the end of the hiring process, Gundersen Lutheran employees sign a compact that outlines how they intend to focus on superior patient care.

"In that context we are very clear that we will evaluate them on those compact components," says McCartney. "Have people in your environment that know how to interact well with patients, who understand patients are at the center and never lose sight of why they're there."

3. Establish transparency and teamwork
Making patient-centered care the center of an employee's outlook on their work from their point of hire prepares them to work as part of a patient-centered team from the outset. The best way to inform an employee about patient satisfaction is to make it matter to them. So implement transparent standards and benchmarks for each unit or department. Without patient-centered care as a priority for all staff, your teams and units will lose focus and synergy.

At Gundersen Lutheran, monthly email newsletters, specific to each unit, examine an HCAPHS survey question, why it is important, and how the unit is performing in this area.

McCartney says it unifies team efforts and sets transparent expectations by showing employees how they measure up within their units, and compares them to other teams in the organization. Then they set competitive benchmarks from outside the organization.

4. Reward the small victories
Because interactions with patients occur on a hard-to-track, minute-by-minute basis, it's important to celebrate and reward small successes.

Peer-to-peer rewards called "High Fives" are a strategic part of reinforcing patient-centered care at Gundersen Lutheran. Units reward team members for day-to-day moments when a high quality of patient care is demonstrated.   

"When they go into that room, even if they are late going into a room to change the bedpan, if they manage that interaction with the patient, it's an opportunity to congratulate someone on how they put the patient at the center of their approach," says McCartney. "We give out over 1,000 of these a year. That's a lot of opportunities to continue the patient-centered care message."

With a peer-to-peer recognition system, employees have regular reasons to notice the good work of their teammates. Encouraging the values of patient-centered care becomes everyone's job, while it also builds positive interactions and camaraderie. It just might make a disengaged employee, who rewards a teammate that upholds the organization's values, check-in about the quality of their own work.

5. Build employee stamina
When a stressed nurse enters a patient's room, that stress enters the patient's environment as well. A study funded by the Robert Wood Johnson Foundation found that increasing nurse-patient staff ratios and improving work environments reduced 30-day readmission rates for Medicare patients with heart failure, acute myocardial infarction, and pneumonia, so it pays on the reimbursement end to build a healthy work environment.

Gundersen Lutheran recently researched a stress management initiative called the Heart Map, an online platform it developed.  Employees, after eight hours of training, learn to take pauses in their work days to lower their heart rates and experience moments of quiet.

After three to six months 70% felt more calm, 22% reported better sleep, 47% reported less anxiety, 37% had improved their mental attitude, and 94% strongly agreed or agreed that they felt better able to handle emotional stress than they did before.

"The primary lever for improving patient experience is creating a healing environment where employees can put the patient first and at the center," says McCartney.

"Employees have to understand that they carry that ability to really transform their own environment, and the patient's level of stress, but as the organization we should provide those tools and the opportunity for that transformation."


Chelsea Rice is an associate editor for HealthLeaders Media.

Tagged Under:

Get the latest on healthcare leadership in your inbox.