When we listen to the voice of the customer (VOC), communication is the one thing they value most from us. This is obvious when we look at how we compile customer satisfaction data. The HCAHPS survey is all about communication between the patient and nurses, doctors and staff. There are questions about how well we communicate about medications, discharge help and responsiveness of staff.
The questions that survey companies ask patients about their experience are all about communication, everything from being informed about delays to including the patient in decisions regarding their treatment.
The biggest complaint we hear is that our communications are poor.
Why?
When we analyze the problem from the patient’s perspective, we realize that the reason the communication is poor is that we can’t tell them how long a test will take, how long until they will be seen, or how long it will take to admit them. Most of the complaints from the patient perspective of poor communication fall into one of these categories.
Why?
Because we don’t know.
Why?
Because no one has ever told us.
Why?
Because we never asked.
Why?
Therein lies the question! Here lies the root cause of our communication problem.
To answer the patients questions, both asked and unasked, we need to have the answers. The most effective way to eliminate the complaint is to have the answers.
Service level agreements are written agreements between departments that specify service expectations between departments. They list the time it takes to perform routine activities and if there is a rush, what both parties must do in order for it to happen.
There is no standard form for service level agreements. The value is not filling in blanks on a form but the discussions that take place to come to an understanding of the expectations we have of each other.
Departmental managers should meet to iron out the details. They should also include a frontline staff member to get the frontline perspective and to make sure what they are proposing is actually doable.
Once the agreement is signed, all staff need to be informed of the details. Now they are in a position to advise the patient how long things normally take, managing their expectations. The agreement should be posted in a prominent place in the unit so staff can refer to it.
There impact of service level agreements on patient satisfaction and HCAHPS scores can not be understated. We can now manage patient expectarions. When we tell a patient, “We’ll have the results of your test in a few minutes and we’ll back …”, there’s an expectation the results will be back quickly. As time passes, patient satisfaction rapidly decreases.
When we are able to tell a patient, “We’ll have your results back in 30 minutes and we’ll discuss..” the patient realizes how long things take, resets their clock and hen we walk back in, results in hand, in less than our promised time, patient satisfaction increases because we managed the wait.
The agreement should be reviewed at least every six months to ensure all times and responsibilities are still valid. Once this is done, it must be reviewed with all staff so they know and understand any changes. Interestingly, one client experienced a decrease in HCAHPS and patient satisfaction scores over a 9 month period. After a root cause analysis they determined circumstances had changed, departments had not shared the changes and patients were misinformed resulting in poorly managed expectations.
The agreement must be made part of any new employee orientation