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Simple Ways to Increase Patient Survey Participation

By Kimberly Shaw, BSN, MBA, FACHE, President of St. Joseph Health

July 14, 2023 Posted in: Leadership

Hospital leadership members juggle a lot of different responsibilities. One of the most important tasks—the core of every hospital mission—is to ensure patients are receiving quality care every time. There are many ways to gauge your organization’s success, but patient satisfaction surveys are one of the best ways to identify and fill in any gaps you may be experiencing. 

CMS also mandates and provides HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) surveys for all hospitals accepting Medicare—over 400 across the country—so it’s important to pay attention to the results. As a leader, you’re already performing rounds and meeting with department heads to assess how things are going, but if you want an authentic peek into how patients feel about your services, HCAHPS surveys offer a unique perspective. 

Of course, these surveys have some shortcomings, which I addressed in a previous article, but HCAHPS surveys still provide intimate, unfiltered access to the minds and hearts of those we serve. Yet, one of the biggest barriers to using HCAHPS surveys to your advantage is getting patients to fill them out—especially satisfied patients—but there are ways to make it happen.

Why You Need More Patient Satisfaction Surveys

To glean the most relevant information from patient surveys, which is to identify trends to applaud and standardize or address and remedy, you need many patients to complete them to ensure the results are valid. Minimal participation can skew the reality of what’s going well and what isn’t, both of which could lead you to make wrong decisions.

I have seen some departments score very well or very poor, but the results were based on low survey participation. When this happens, it’s hard to really understand what’s happening in a given department. Having a higher survey response normalizes the extremes and provides a better picture of actual department performance. Rely upon low survey response outcomes, and you risk over-correcting an effective, efficient department or under-correcting a department with significant improvement opportunities.

However, recognizing the need for more survey participation is only the first step. You need to find the best approach that will help increase patient interest in completing HCAHPS surveys, which are quite long! 

Seeking Positive Feedback

One of the biggest obstacles to increasing survey participation is the litany of CMS regulations we must follow. We can ask patients to fill out a survey, but we must be very careful how we script toward survey questions to avoid overstepping boundaries set by CMS.

Fortunately, scripting does not have to be exceptionally complicated. Because unhappy patients are most likely to complete the survey without encouragement, spend your efforts on engaging patients who indicate they’ve had a pleasant, positive experience. 

Let patients know they will receive a survey in the mail after discharge, and inform them that the best way to recognize staff they appreciate is to fill out the survey, naming staff members who exceeded their expectations. This suggestion seems to generate some good will on the patient’s part, as they often want great staff to gain recognition.

As simple as this conversation may sound, it’s not always easy to do. Many health care professionals are afraid to even mention surveys because they don’t fully understand what CMS allows you to say. To avoid accidentally saying the wrong thing, they opt to say nothing at all. Leaders should educate staff on what is allowed and acceptable to discuss, which can encourage them to engage patients with confidence.

Staff should also have a clear understanding of the survey’s scope. This also increases their confidence when broaching the topic with patients. Plus, when staff understands what the survey is after, they can tailor their care to ensure these items get addressed without overtly scripting their patient care. HCAHPS offers a wide variety of training materials to help you get started, including podcasts about improving response rates.

Also, and this is important, if you want your clinical staff to help, it’s important for leadership to model the behaviors they want of others. Use patient rounds as a learning opportunity and to recognize staff for good work being done. Staff members should never feel like the leader is going around with a clipboard and a critical eye. I encourage leaders to always praise staff in public for good deeds.

Where Is That Survey Going, Anyway? 

Conversations to increase survey participation can and should happen throughout a patient's stay, but only if you have the correct patient information. Otherwise, those conversations will be fruitless.

Patients receive surveys via USPS. If you have the wrong home address, your survey will never reach them, and that patient has no opportunity to participate in a HCAHPS survey. 

How and where do you remedy errors? At the front door of your facility.

Hospitals are busy places. Frequently, the check-in process gets rushed due to the patient’s condition. In these cases, intake staff members necessarily rush through processing, quickly confirming the patient’s correct address and phone number. The patient, however, may not be concerned with ensuring a proper address in your hospital computer system, especially if they’re focused on accessing vital health services in that moment.

Though understandable, this presents an obstacle to increased participation in patient satisfaction surveys. Without a survey to fill out, that patient cannot supply you with feedback to bolster good practices or drive change where needed.

Slowing down the intake process, even if it’s only to ask patients one more time if the mailing address is correct, can help reduce the amount of incorrect contact information in your system and ensure more surveys get delivered to the right address. 

Of course, treating your patients well throughout their stay, listening to their concerns and responding to their requests with sincere empathy can also go a long way in getting more surveys completed.

How does your organization encourage patients to complete HCAHPS surveys?


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