July 1, 2017

Nursing Confessions | HCAHPS Blame Game

Nursing confessions are random thoughts from anonymous bedside nurses. Read, comment, share & enjoy

"I worked on a unit once that received low HCAHPS (Hospital Consumer Assessment of Healthcare Providers & Systems) scores from patients and their respective family members. Due to these results, the unit manager enforced a new call light tracker system. When a patient pressed their call light, the unit secretary would mark it on a form. At first, it was just a tracking tool. But like most things in nursing, the tracking system soon turned into a way to assign blame. Management felt these scores (overall in nature) were directly related to nursing practices and performance. Therefore, if consequences were created, the behavior should improve, and better scores would result. A week later, the call light tracking system was revised. If any patient used their call light more than three times per shift (in a 12-hour interval), the nurse would receive a mark. Two marks in a week and you received a verbal warning regarding your "inability to properly care for your patients." Two verbal warnings in a month and you received a formal write-up. Two write-ups within a six month period and you were terminated. The reason for the patient pressing the call light wasn't even a factor in this plan. As we all know, there are various reasons why a call light is pressed. There can be an actual medical need or someone paging the nurse because they have misplaced their iPhone charger. As a result, nurses would recommend patients NOT use their call lights and either wait (until hourly rounding) or oddly enough, yell if they needed anything. No one wanted to lose their job due to a patient simply needing something. Isn't nursing about people needing caregivers and caregivers tending to their needs? Why then are nurses being punished for the very platform healthcare was built upon? Of course, this plan backfired and resulted in an increase in falls and decrease in productivity. I wish managers would properly analyze the why, instead of just reacting. I reviewed our score, our lowest score was based on provider communication. Yet, no one wanted to work on that aspect of the survery."

Has your hospital implemented an HCAHPS improvement initiative? If so, what is your opinion on the matter? Have your priorities as a caregiver changed due to this program? Is the improvement program only nurse-focused? Share your thoughts.