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| Nationally,
several health care consulting groups rate hospitals
on patient satisfaction measures and other quality
of care issues, including patient safety and clinical
outcomes. |
Keni Horiuchi, MSN, RN, is the leader of a pain management
team whose quick interventions at the bedside helped
boost patient satisfaction rates at North Bay Healthcare
System in Fairfield, Calif.
Patient satisfaction data pinpointed pain management
as an area for improvement at the nonprofit health system,
and the nursing team started by Horiuchi five years
ago has helped the hospital achieve dramatically better
results.
"Pain management is very important. It affects
the entire patient experience," said Horiuchi,
a clinical nurse specialist in oncology.
The pain team now consists of five specially trained
nurses who can be called to the bedside for rapid intervention
and 20 to 30 more RNs are scheduled to go through the
program soon, Horiuchi said.
"These are nurses who can advocate for the patient
and recommend what needs to be done," Horiuchi
said. "They can assess a problem and call the doctor
with what's going on."
Horiuchi said a common question on patient satisfactions
surveys is: Were you asked about pain? "Patients
now answer 'yes,' but it wasn't always that way."
The health system, which includes two hospitals and
a hospice, scored high marks in the 2003 Patients' Evaluation
of Performance in California (PEP-C) project, the largest
publicly reported and most comprehensive hospital patient
survey of its kind in the nation. Even with high scores,
the survey offers clues as to where improvements can
be made, according to Kathy Richerson, MS, RN, vice
president of patient care and chief nursing officer.
North Bay was one of 181 California hospitals that
volunteered to participate in the PEP-C survey, Richerson
said, because the methodology used by National Research
Corp./Picker provides scores that can reveal problem
areas. "The NRC survey shows where we can place
our efforts to affect patient satisfaction the most,"
she said.
The pain management program included an educational
outreach to the system's 400 nurses, Richerson said,
and resulted in effective changes that went beyond just
providing drugs and medications. For example, changes
were made in how care was documented to show what therapies
were most effective. A noise reduction program also
was implemented.
"The high scores in PEP-C show real evidence that
the time put in was worthwhile," Richerson said.
The PEP-C survey, Richerson said, also enables participants
to compare results and to take part in conference calls
to discuss overall outcomes and trends and to share
solutions with other hospitals. Data from the survey
also are shared with nurses during recruitment and orientation
because patient satisfaction is a key indicator of a
quality working environment, she said.
Marsha Nelson, RN, helped develop and launch PEP-C.
The California survey results, she said, provide nurses
with insight to a hospital's culture, morale and how
employees are treated.
"Studies show a direct correlation between employee
satisfaction and patient satisfaction," said Nelson,
vice president of the California Institute for Health
Systems Performance.
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