Nurse-Patient Communication Can Help Hospitals Raise Crucial Scores

Thursday December 23, 2010

As healthcare organizations strive to improve quality metrics as mandated in the Affordable Care Act, nurses must emphasize communication to ensure patients understand the care they receive.

That advice comes from one of the authors of a new handbook that advises hospitals on how to prepare for the pay-for-performance mandate in the new law.

“Nurses are highly skilled in the technical aspects of our job,” Karen Cook, RN, said in a news release. “Where we don’t always excel is in helping patients understand what we’re doing and why we’re doing it.”

Cook is one of the authors of “The HCAHPS Handbook: Hardwire Your Hospital for Pay-for-Performance Success.” HCAHPS, or Hospital Consumer Assessment of Healthcare Providers & Systems, conducts an ongoing standardized national survey for measuring patients’ perceptions of their hospital experience.

Since 2007, most hospitals have had to submit HCAHPS results to receive full Medicare payments. Beginning in 2013, based on Affordable Care Act stipulations, a value-based purchasing plan will essentially make HCHAPS results a pay-for-performance measure, rather than merely pay-for-reporting.

Nurses will play a vital role in helping their facilities achieve optimal HCHAPS results. When nurses “help patients ‘connect the dots,’ ” Cook said, “we see HCAHPS results improve.”

Cook notes that many nurses already have the foundation in place to create good clinical outcomes. As an example, she cites hourly rounding.

“Anyone who is practicing hourly rounding is already doing eight very specific behaviors every time you’re in a patient’s room,” Cook said. “To narrate our care, we just explain what we’re doing. We tell her why the alarm went off, why we’re checking her IV bag, why we’re checking her blood pressure.

“In the process, we put her at ease and we build trust and credibility, and HCAHPS results go up.”

Cook describes the role of nurses in patient communication as narrating care. She says the crux of the role is to ease anxiety and fully engage with patients, rather than going through motions while checking off list items.

More profoundly, she said, nurses have an opportunity to build relationships that allow them to make the kinds of discoveries and exert the sort of influence that generate better clinical outcomes.

“That’s really what drives most nurses to do these tactics,” Cook said. “When they understand that better quality and better HCAHPS result go hand-in-hand, they’re on board.”

• Discover Nursing Searchable Nursing Scholarship Database
• Nursing Education Loan Repayment Program
• Health Resources Services Administration Student Scholarship Programs
• Student Guide to Financial Aid from US Dept. of Education
• HRSA Bureau of Health Professions Scholarship Program

Tuesday, April 26th, 2011@ 9am
UN Headquarters: Visitors’ Center, First Avenue & 44th Street