Not long ago, I was at a patient experience conference and decided to sit in on a breakout session given by a hospital that had recently received an award for raising their H-CAHPS scores. We’re all looking for the secret sauce and I was interested in hearing how they did it.
The two presenters talked about how they took a specific question from the survey and made that their focus. They conducted huddles on that question at the start and end of every shift, they measured and posted results in every unit, the unit managers and charge nurses socialized it throughout the day every day, and individual coaching was given to everyone who wasn’t performing as expected for that particular question.
The results were impressive. The whole time this was in place, scores went up considerably and patient comments reflected that the practice was being done. It was great.
And then they focused on another question. And guess what happened to the first question. Did those results sustain? Did they continue to do those things they’d been drilled on for weeks before? Nope. They fell off like Humpty Dumpty.
The results for the question they were now focused on were great, just like the first one had been. But those didn’t last either. Whatever had the intense focus performed well. Nothing else did.
So I raised my hand and asked, “Can you speak a little about sustainability? When do these behaviors you’re coaching for become just part of a normal day, ‘this is how we do things here’? Can you explain why they weren’t sustained over the long-term?”
They looked at each other for a moment and one of them said, “Well, you know, we ask an awful lot of our nurses. They have so many things they have to focus on; we think we can only ask so much. One thing at a time.”
I’m sorry… you got an award for this?
This, in my opinion, is what’s wrong with so many hospitals’ approaches to improving patient experience. Unless it’s part of your culture, unless it’s what employees commit to, unless it’s “this is how we do things here,” you don’t have real improvement. You have compliance, but not commitment.
I was so disappointed when I left that session. Any one of us could have given that very same presentation. We have all done that very method of performance improvement and gotten the same results. Why do we keep doing it that way?
It seems that’s exactly what so many leadership teams want. They want a spike in improvement that they can show to their bosses. Are we all really that short-sighted? Really? We’re celebrating a blip on a spreadsheet. That’s just not how I do things. Whenever you have a huge spike, you will have a huge fall. Patient experience is a culture, not a program, and it takes time.
It’s time we start rewarding those hospitals that put in the work over the long haul and sustained those improvements over months and years. Let’s do it the right way and feature them at the patient experience conferences.
What is your leadership team celebrating?