Improving HCHAP scores

One of the big focuses at my hospital right now is improving our HCHAP scores. What are your hospitals doing to improve hchap scores? How is the staff being educated on improvement tips?
One of our big issues right now is improving pain scores and information relayed to patient's regarding side effects of medications. I find these side effects to be one of our biggest downfalls. Medications have SO many side effects and I am looking for an effective way to teach the patient's about these side effects. How is your hospital going about this?
My hospital was and is trying to improve our scores through improving pain scores, bedside rounding (with oncoming/offgoing shift) and hourly rounding. Now that all sounds lovely, but I find management doesn't give any extra support or doesn't do their part to increase the scores. Extra staffing is huge imo for patient satisfaction. One nurse running around with x amount of patients can be detrimental, how much can one person do? Simply adding 1-2 extra ancillary or even nurses to each shift would make such a difference.

Our hospital is focusing on ER to med/surg flow and discharge to home process. We are attempting to get the pt's out of ED in 3 hrs from door to floor. Our part is going well, but ED can't seem to adhere to the process to save their lives. They like the old way that never worked then..Discharge to home is in the works as we speak. Our goal is to have pt's out the door by noon. Fingers crossed. To answer your question about meds. We will print out common side effects from our website and if the pt still has questions, pharmacy will round and educate as well.

I agree, I think part of the solution to almost any of the problems in the hospital is better nurse to patient ratios. We can only do so much! I love the idea of Pharmacy doing rounds and answering questions. Do they round on a regular basis? Or do you have to call and ask them to talk to a specific patient?

There are certain criteria they will round on routinely. Those are the new diabetic, CHF and anti-coag pt's. They come to interdisciplinary rounds every day and if there is a question from a pt concerning a med, they will put them on the list and stop by and see them. I do agree on the nurse/pt ratio. Nurses, with high acuity, become task oriented and put education last on the list.

I am an excellent nurse.. I could care less about esoteric SCORES. I have all I can do to eyeball my peeps and get them their meds.The only way to improve satisfaction is to GIVE ME LESS PATIENTS.

Quote from Been there,done thatI am an excellent nurse.. I could care less about esoteric SCORES. I have all I can do to eyeball my peeps and get them their meds.The only way to improve satisfaction is to GIVE ME LESS PATIENTS.

In home health, we have had HCHAP scores for a year or more now. Our agency is constantly sending out e-mails to the staff about how to improve this or that, and quarterly we get our HCHAP scores in e-mails and how they relate to other agencies both state wide and nationally. The other crazy thing that they do is some "role-play" type things during our monthly mandatory staff meetings. I guess it's so that they let you see how the patient perceives the kind of care they are getting. Most recently we had a couple of the management staff putting on a "role-play" for our staff, and it went something like this:Nurse sitting with her laptop typing away saying, "Mrs Jones, do you take any medication? Let's take a look at all your medication." Nurse still typing away. Mrs Jones goes to get her medication and sets them down in front of nurse. Nurse stops typing long enough to pick up first pill bottle and says, "Oh, you are on lasix, this is 40mg and you take it once in the morning, is that correct?" and proceeds to type while Mrs Jones says, "yeah, I take it every day, but I don't like to take it on Sunday when I go to church because it makes me pee too much and I can't control my water while I'm in church service." Nurse still typing away, then says, "Oh, you take Potassium 10meq every morning along wiht your lasix, is this correct?" Nurse typing while Mrs Jones says, "yeah I try to take those Potassium pills but they are so big I have trouble swallowing them, and they taste so bad when I break them up." while nurse continues to type... anyway the role play goes on and on, and it's CRAZY. They end the role-play by saying you need to put your laptop down and make eye contact with the patient and go over their medications and make sure the patient pereives that you really care about their medications, how they take them, what they are for etc... I get this. Patient thinks you don't care about them or their meds if you are burying your face into the laptop. And management thinks that if you just set your computer aside and discuss each medication then the patient will perceive that you really care about them, and how they take their medications. This is great in a fairy tale world, when you don't have 6-8 patients per day all with poly-pharmacy and it mandatory that you document on each of the meds along with all of the teaching guidelines, and a note for the visit. I find that doing wound care and assessing vital signs, and a general assessment may take 20 minutes, but the mandatory paperwork that goes along with this visit will take an additional 30 minutes. Where has health care gone? We need to teach meds for the patient to be safe, we need them to have the wound care, and now all of a sudden we have to do it all without the use of the laptop, but still get it all documented, and documented in a timely manner so that it is done and in the system before 8am the following day. AND make sure the patient perceives that you CARE about them. And management gives you these handouts about what to say to the patient so that it triggers them to chose the highest scores when they complete the HCHAPs survey. I didn't become a nurse 25 years ago to "role-play" with any patient. I didn't become a nurse to make these stupid statements just so someone will perceive that I give good care. I give good patient care, have great outcomes, and my documentation is done.Years before HCHAPS we had press-gainey surveys that went out to the patients. Our agency wanted every patient to score each category on the press-gainey survey with a 5 (I guess this was the best number we could get), so they spent thousands of dollars making badges the the staff were to wear every day. They were big green pin on badges that just had a big 5 on them. We were supposed to wear them, and if the patient asked, we were to tell them that when their survey comes in the mail about our service, we would appreciate if they gave us a 5.I guess all I am saying is these surveys are ridiculous. Basing pay on a perceived patient satisfaction is crazy. Most of my patients live in a rural community and they can't read anyway, but if they can read, then they are the ones that complain about everything you do, even though you do it right to a fault. They are miserable, old, grouchy people that couldnt' be pleased about anything in life because they are sick. And if I had a magic wand or the magic cure pill in my pocket, I still doubt that would make them happy. And I do believe that the HCHAPS score would still be low. Perception vs Payment... not Good Outcomes vs Payment, and not Excellent Care vs Payment. Blaahhh, I could go on and on....