Sanford Health Gets it Backwards (Page 47)

By Mathew Keller, RN JD
Regulatory and Policy Nursing Specialist

Limousine service, upgraded television sets, nurse-to-patient “scripts,” gourmet food service, nurse uniform requirements. Hospitals all over the U.S. are offering more “customer-centric” patient care in order to increase patient satisfaction scores, which are becoming more and more important to raise and maintain Medicare reimbursement amounts.

These efforts, however, often have unintended consequences.

In the first place, customer-centric interventions rarely (if ever) improve the quality of care patients receive. Rather, they merely improve patients’ perceptions of care.

That’s why Sanford-Bemidji has it all wrong in their current push to link nurse pay to patient satisfaction scores. A patient’s perception of their care has more to do with a good customer-service model than a good healthcare model, but Sanford continues to insist that nurse pay be linked to patient satisfaction scores.

Perhaps the biggest issue with this approach is that nurses have little control over the factors that research shows improve patient satisfaction scores the most. Quality of food service, wait times, physician attentiveness, even staff uniform colors are all factors in patient satisfaction scores—none of which nurses have control over.

The research also shows that short staffing, a constant issue at Sanford-Bemidji, is a significant factor in patient satisfaction scores. Short staffing is inherently unsafe and puts patients at risk.

Instead, focusing on safe nurse staffing actually improves the quality of care patients receive, not just their perception of it. The literature shows that improving nurse staffing while controlling for variables (including physicians, LPNs, and nursing assistants) significantly cuts the risk of mortality, lowers the incidence of medication errors and other adverse events, cuts patient readmission rates, reduces nursing-sensitive negative outcomes, and even saves hospitals and insurance companies money—and that’s just the tip of the iceberg.

If Sanford administrators actually care about the quality of care in their facility, perhaps they should consider linking nurse manager compensation to safe staffing. This would be much more effective in improving quality of care than short-sighted attempts to link bedside nurse compensation to patient satisfaction scores.