HealthStream Research’s experts have been developing a wide range of recommendations to help hospitals improve on each and every HCAHPS survey item. This month, we will focus on how to improve patient perceptions of courtesy and respect by nurses and physicians.  Even though these are two separate HCAHPS survey items (one for nurses and one for doctors), it takes a comprehensive team-based approach for improvement.  In the eyes of the patient, you are all one hospital.  The entire patient care team (everyone that interacts with the patient) must work together to improve perceptions of courtesy and respect.

What the Patient Care Team can do:  Each patient’s perception of the patient care team’s courtesy and respect is not only based on the behavior of the team, but also how the patient care team members prepare each patient for contact with other team members.  This means that the patient care team should talk to each patient about the staff member they are about to meet, highlighting the team member’s credentials, skills, and approach to excellence.  In other words, build excitement and expectations before patients meet another patient care team member. 

What the Physicians can do:  If physicians are not showing courtesy and respect, the patients’ perception of courtesy and respect for everyone may be tainted.  (Of course, these physician recommendations are all applicable to the rest of the patient care team as well.)  To address physician courtesy and respect, it is essential to manage two important issues—undivided attention and simple communication.  To show patients they have the undivided attention of the physician, the physician should sit down beside the patient.  In fact, patient rooms should include a stool for the physician (and the rest of the patient care team) to use for this purpose.  To address simple communication, physicians should strive to avoid technical terms and stick to simple language.  Use swelling instead of edema, blue instead of cyanotic, heart attack instead of myocardial infarction. 

What all can do: 

• Establish a policy for the entire patient care team for everyone to introduce themselves upon first contact with the patient. 
• Give patients a journal and encourage them to write down care-related questions as they think of them.  When any member of the patient care team enters the room, ask the patient if any questions were put in their journal.
• Always tell the patient what will happen next, and when it will happen.  Avoid vague phrases, such as in a little while. 
• Tell patients that you wish to treat them with the highest level of courtesy and respect.  If patients are told that your goal is to treat them this way, they will be more likely to recognize your efforts.
• Avoid using first names.  Though acceptable to many, using last names provides a heightened air of courtesy.  Additionally, there certain demographic groups that will take offence to being called by their first name, while conversely very few will be offended by using their last name. 
• Build behavioral accountability through the use of staff business cards.  At the Outer Bank Hospital in North Carolina, accountability for courtesy, respect, and clinical excellence is addressed through staff business cards.  “When anyone interacts with patients, they give them a business card.  This way, the patient has a name to attach to the caregiver.  This also shows each patient how committed we are to delivering the best care,” said Donna Cheek, MSN, MHA, Vice President, Clinical Operations.

For the latest information and updates, visit our dedicated HCAHPS website at www.hcahpsinfo.com—the premier destination on the web for essential HCAHPS knowledge and expertise.