In October 2012, Medicare / Medicaid will begin withholding a portion of it’s financial reimbursement to hospitals. The withheld reimbursement will be returned based on the results of a standardized customer service survey completed by patients who receive care. Hospitals that score high will receive the entire reimbursement. Hospitals that score low will receive a percentage of the reimbursement.
On March 14th the New York Times published an Op-Ed written by Nurse Theresa Brown in which she suggests that patients won’t give hospitals high ratings when treatments are painful or when patients cannot be cured. She says that the survey “needs to incorporate questions that address the complete and expected hospital experience.” Her concern is that “in order to heal, we must first hurt.”
Rather than enhancing the patient experience, Nurse Brown would like to change the survey. She states, “Judging care in terms of desirable customer experiences could be expensive and may even be dangerous… [and] could easily put pressure on the system to do things it can’t at the expense of what it should.” I get the sense that she believes patients have unreasonable expectations and should be grateful for, “the specialized, often painful help that only we can provide.”
For me, the delivery of quality health care is holistic and a patient’s perception of their care is important–patients heal faster when they feel safe and comfortable. Hospital staff must understand and anticipate the expectations of patients and manage those expectations through validation and education. At the University of Texas, I was taught that 50% of a nurse’s job is to teach and UT’s curriculum includes a great deal of communication content. I was trained that it is my responsibility to provide psychosocial care and comfort to my patients and I am happy to do so.
I am also happy that Medicare / Medicaid is taking patient’s satisfaction seriously and withholding money from hospitals with low satisfaction ratings. America was built on consumerism and hospitals can’t continue to ignore the growing dissatisfaction of the public. Our healthcare system is in a woeful state and I believe that linking reimbursement with patient input may contribute to positive change.
Originally published in March 20, 2012.