It seems like everybody is struggling with the issue of quiet. If you think your scores are fine, I make this observation: no one can be objective about the service they provide while they’re providing it. Employees develop blinders after one hundred days of working somewhere; they stop seeing as an outsider and start seeing as an insider. As soon as this happens, they are no longer objective. I like to say, “you can’t read the label if you’re inside the bottle.”
Here are some of the “Quiet at Night” issues that I tackle most often – they may sound familiar!
Partially Private Patients
“Creating quiet environments is difficult because we have semi-private rooms.”
There are always options for improving, even when your patients have roommates. Here are some suggestions:
- Request that roommates have respect for each other, even as they are recuperating; ask them to try to manage and moderate their own sound levels
- Distribute ear plugs and white noise machines, if available
- Set up an acoustic baffle – available in endless shapes and sizes, a baffle cuts noise like a champ
- Consider a patient’s potential noise level when assigning beds
The Colleague Conundrum
“What do you do when a doctor is doing some charting or talking on the phone, and he or she has a voice that’s loud? How do you tell them to hush up?”
All colleagues, across all departments, should be empowered to remind each other about the importance of quiet in a hospital—have your team (or your whole facility) agree on non-verbal signal, like a tug on the ear; usually that will be enough to remind someone that they need to moderate their noise levels. From nurses to janitors, doctors to executives: if someone is noisy on a unit, they are preventing a patient’s rest.
This is the reason that total staff engagement is essential for improved HCAHPS scores. I know there are some people think that HCAHPS is just about nursing, but it’s not; nurses depend on IT, HR, Pharmacy, Maintenance, and everybody else—every employee in a hospital is either directly or indirectly impacting the patient’s experience, which means that every employee is responsible for HCAHPS results; consequently, every employee must be invested in improving them.
“I get my HCAHPS scores and I have no idea how to fix them.”
Dealing with HCAHPS scores can feel like a whac-a-mole contest; as soon as you get one under control, another one pops up. You can’t take your eyes off them for a second! This blog is designed to help you improve and sustain your scores, and if you take my recommendations to heart, I have no doubt that your patient experience will improve. If you need more dramatic intervention, We have developed the HCAHPS HOPE Plan (Hardwiring Outstanding Patient Experience) with HCAHPS challenges in mind. The HOPE Plan isolates the specific best practices that you can implement to improve HCAHPS scores and organizes them into the following seven sections.
1. Specific Best Practices
2. Tools, Equipment and Resources
3. Staff Skills and Behaviors
4. Sentence Starters
6. Leader Competencies
7. Frontline Competencies
The Take Away
Give every staff member permission to improve the patient experience. I can practically hear some of you say “But Brian, my employees are already empowered!” Don’t make that assumption – be explicit about the scope of empowerment and responsibilities. Also, there is always something that could be done to improve your HCAHPS scores – just think outside the box!
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