In yesteryears the prevailing memory in patient’s minds was their hospital experience was going to be less than optimal; food was going to be atrocious, cleaning will be inconsistent and indifference was generally the perceived attitude of the caregivers. Today government involvement to ensure the patient’s overall experience by leveling penalties and rewards to the hospital in the form of government reimbursements. This system is known as the Hospital Consumer Assessment of Healthcare Providers and Systems Survey, or HCAHPS. Hospital Environmental Service Departments (EVS), with equal face time with the patient as Nursing, play a key role in contributing to the overall success in HCAHPS results.
Patients may be unable to speak to the details of their hospital clinical experience but they can tell you if their room is clean, if dust bunnies galloping down the corridor or if their trash is overflowing. They remember kind words and caregiver focus on their wellbeing during their stay.
Quint Studer, founder of the Studer Group®, described a situation when he was a patient. During this experience, Quint conveyed a story of several people entering his room and not explaining who they were and what they were there to do. This indifference to him as an individual only added to his anxiety, creating the antithesis of a healing atmosphere. This experience helped to prompt Quint to create his company and author his book, Hardwiring Excellence, which is now a highly renowned work in improving the patient satisfaction experience.
Thus began the dawn of a new concept in patient interaction with the Environmental Service associate. This interaction, coined by the Studer Group®, is referred to as “Acknowledge, Introduce, Duration, Explanation and Thank You”, or AIDET®. This tool is essential with reinforcing in the patient’s mind the role of the EVS associate and in transmitting a genuine concern for the patient’s welfare in their service to that patient.
Another facet of fortifying patient interaction is by promoting those individuals who work side by side with EVS associates. An effective way in which this done is through a concept called “managing up”. The dialogue may go something like this:
“Mrs. Jones, you now know what my role is in your care. I see that you have Judy Jackson as your assigned Nurse today. Boy, are you lucky! Nurse Judy has years of experience and is one of our most qualified Nurses.”
The managing up technique services two purposes; it sets in good light the Nurse serving this patient and it promotes team comradery between Nursing and EVS.
Yet another aspect of delivering service in patient care is provided in delivering the “promise” to the patient. Don Dean of the Studer Group® in his recent article, “AIDET Plus the Promise”, describes the service promise to the patient that goes beyond the delivery of AIDET and links a “promise” to the patient in providing care. The Nurse “promises” and she and her team will manage the patient’s pain and frequently asks how they are doing with this. Likewise, the EVS associate will “promise” to thoroughly clean the patient’s room and inquire daily as how they are doing.
Multiple visits to the patient room by EVS associates who explain to the patient why they are there and what they are doing reinforces positive service delivery. In addition to the thorough cleaning of the patient room, EVS associates will return to empty trash, spot clean and provide a turn-down service at bedtime. These are often referred to as “touches” in the EVS business and they go a long way in promoting patient care.
Patient rounding by EVS leadership is another feature in the Studer® quiver that assists the EVS Department in achieving positive patient satisfaction.
Practice Makes Perfect
Team meetings and daily team huddles provide excellent opportunities for reinforcing patient communication skills. One of the better ways to do this is in role playing which uses a group setting to teach and reinforce new skills.
Other Important Elements
Other important ingredients to insuring success in the delivering excellent patient service and satisfaction include:
•Senior hospital leadership commitment to this process improvement
•Shadow rounding by EVS leadership to observe and coach EVS associates
•Monitor and communicate HCAHPS outcomes to the clinical unit EVS associates to gain their support and participation in achieving improved scores – make a point of celebrating things going well
Like most other things in life, things don’t tend to happen by accident. It is a commitment to practice, rounding, metrics analysis and communication that wins the day in achieving superior satisfaction and HCAHPS results.