HCAHPS and the nurse introduction.

Can nurses improve the floor or unit’s HCAHPS scores? Apoor HCAHPS score will directly affect the reimbursement for patient care. If you tell nurses that the HCAHPS scores are down or low and you get a response to the effect that this is not a hotel, this is a hospital, or I am trying to keep my patients safe and alive, not pamper them. Unfortunately, society today is all about the experience and ratings! Blame our society, that is too afraid to make a decision without reviews and that same society interacts more online than they do in real life.

Ideas that Improve the Scores.

This blog is not about why or how this became mainstream, but how to excel. I bet some nurses already moved past this blog by now. But, yes, it can happen, if we can convert the thinking from solely keeping the patients alive to include some patient pampering. You will also find pampering can lead to more time in the day for the nurse to get tasks completed. Now, that just sounds crazy, but so true.

Effective communication.

The first item to improve HCAHPS scores is effective communication. Nurses think, "I talk to my patients." Talking is one thing, effective communication is something different. Now a nurse gets a new patient, to add to the his\her patient load, and the nurse rushes in and tries to get the whole admission done fast in order to move onto the next task at hand.

Can a patient detect a rush job compared to someone who actually is interested in that person’s wellbeing or recovery? By rushing, think how much is missed in teaching at the admission. This does not mean go slow on purpose, but it does mean look for cues to instruct the patient.

Teaching should start with the admission.

Do not think that the patient will get all this instruction at discharge. Start teaching at the admission as it helps the patient digest the instruction and when discharge comes, it fortifies that teaching. Take the “rush” mentality out of the admission. If nurses are said to be excellent observers, why do we miss the obvious cues of patients with burning questions?

Answering questions at the start of a hospital stay and observing the patient for cues of concern, will improve HCAHPS scores.

Fortify the teaching.

During the patient's stay, fortify the teaching. Ask questions in yourreport with such as the following:

  • What was taught during your shift today?
  • Did the family have any questions today?
  • Did the doctor talk with the patient today?
  • How did the patient take the interaction with the doctor?
  • How many new medications were ordered today?

It may add a little more time to the report, but you get a better understanding of your patients.

Keep patients updated.

During their stay, keep your patients updated. Saying to them, “You are scheduled for a test today,” may give them a visible itinerary of the day, but effective communication will explain what the test is for in terms the patient comprehends.

Also, let the patient know what you are doing and why it needs to be done. Nurses are getting less engaged with their patients and more engaged in their documentation. I say do both!

It is all about the patient.

The mode of documentation has changed from paper to electronic, but it is still about the patient. Just because you type, does not mean the patient does not need to know what is going on and what is in store for him\her. Patients are human too. Did you know that when you do a round and see a patient for about 11 seconds, that if you say to them that you are you are making sure they are ok, this can save you hours of call lights throughout the day?


When you give medications, do not just pour tablets in a cup and say, "here, take these." Look for clues that the patient may have a question about their medication, or even a question about something they took for years that no one has been able to answer.

If the patient detects rushed or busy nonverbal cues from the nurse giving them their medications, they will be afraid to ask.

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