Feature article for nurse managers and administrators - Current Nursing in Geriatric Care, Freiberg Press Inc. (USA)

1. Personal Improvement
Why you need staff with excellent customer
service skills to stay ahead of the game
By Lorena Tonarelli
“For Medicare beneficiaries to get higher
Poor quality of care has long quality health care, our payment system needs
been a concern, and historically to encourage better care”
handled with fines, penalties and
other sanctions.
This punitive approach, howev- Poor customer satisfaction Medicare payments affected
er, has failed to produce any real, Now, one of the best ways to Poor customer satisfaction is
long-term improvement. evaluate a facility’s performance not exclusive to nursing homes.
So, the Centers for Medicare is to look at its customer satis- Assisted living facilities, hospi-
and Medicaid Services (CMS) has faction scores. tals, and physician clinics also
adopted a different strategy alto- And that’s where the problems have their share of unhappy pa-
gether. start. tients and disgruntled family
A national survey of nursing members.
Medicaid Pay For Perfor- homes, conducted by Harvard And there are pay-for-perfor-
mance School of Public Health and the mance programs for these set-
The agency has launched the Kaiser Family Foundation, tings, too.
Medicaid Nursing Home Pay-For- found that, of the interviewed Starting in October 2012,
Performance (P4P) program, residents and their family mem- some Medicare hospital reim-
which focuses on rewarding facili- bers, bursements will be partly
ties that do well, rather than just • 37% were generally dissatis- based on patient experience
punishing underperforming ones. fied with the quality of scores, as mandate by the Af-
Essentially, under the P4P nursing home services re- fordable Care Act.
program, Medicaid payments “For Medicare beneficiaries to
ceived.
to nursing homes are deter-
• 32% denounced a lack of resi- get higher quality health care,
mined by their performance
dent-appropriate recre- our payment system needs to en-
on care quality measures; the
better the performance, the ational activities. courage better care,” says a
higher the payments. • 25% reported residents being spokesperson for the Department
Expert in long-term care policy physically restrained. of Health and Human Services.
and administration, Dr. Greg Air- • 25% said residents had been “Paying hospitals for the quali-
ling, of the Indiana University “treated badly or abused by ty of care they provide takes us
Center for Aging Research, says staff.” closer to that goal.”
the rationale behind this ap- • 25% said residents “were not
proach is that, “if better perfor- generally bathed and Customer skills WANTED!
mance is rewarded with propor- groomed in a satisfactory So, what does all this mean to
tionately higher payments, then, way.” nursing homes, hospitals and
providers will strive for high- • 24% reported staff being un- clinics across the country? It’s
quality care.” interested in family mem- quite simple.
bers’ concerns about their In order to achieve high perfor-
loved one. mance and, consequently, benefit
• 23% said residents they knew from reimbursement programs,
One of the best ways to developed pressure ulcers. avoid sanctions, maintain a good
evaluate a facility’s per- • 21% said staff “do not provide reputation, and match the com-
adequate help at meal- petition, they must keep pa-
formance is customer times.” tients/residents and their fami-
satisfaction scores. lies happy.
8 Current Nursing in Geriatric Care February 2012

2. How do they do this? By en-
suring staff at all levels have
excellent customer care skills.
Experience from healthcare
and other industries shows
these skills can be taught
successfully with ongoing,
comprehensive training.
They include the ability to
• develop positive relation-
ships with family mem-
bers,
• listen and respond to con-
cerns,
• deal with difficult patients,
• handle complaints effective-
ly,
• show empathy and sensitivi-
ty, and
• be a productive team mem-
ber.
Staff-family relationships: Dos and don’ts
A top priority for improving
nursing home customer satis- “Research has shown that family members value ef-
faction is to create a culture
that emphasizes the impor- fective relationships with nursing home staff”
tance of good relationships be-
tween staff and the residents’ Staff-family relationships...
their loved one receives, or
family. Dos:
that could make their loved
“Research has shown that Utley-Smith and a team of col-
family members value effec- one’s stay in the home more
leagues have conducted a six-
tive relationships with nurs- pleasant.
month study involving two long-
ing home staff, whom they • Keep family members con-
term care facilities, which has
see as a source of informa- stantly informed about their
helped identify steps nursing
tion and a means of remain- loved one’s conditions and
homes can take to promote good
ing involved in care deci- care through a system of reg-
staff-family relationships.
sions,” explains Dr. Queen ular face-to-face, telephone,
Utley-Smith, a nurse educa- Here is what these steps are:
and written communications.
tor at Duke University. • Make sure the residents’ fam-
As part of this system,
And that is what the facility ily feel welcome.
staff should ask if there is
should strive to give. Staff should always be
nice and pleasant; they anything, in particular,
should show a genuine they should do for the resi-
Family can assist in plans dent.
Besides, add the researchers, interest in how family
members are coping with They should also promptly
“family members who possess inform family members if a
information about residents’ their loved one’s stay in
the facility, and should problem occurs.
preferences, habits and goals of In one of the two facilities
address any concern
care can assist staff to establish involved in the study, this
families have.
an optimal plan of care that system led to happier, more
• Encourage family members to
contributes to resident attend care planning meet- satisfied family members
wellbeing.” ings, and to share informa- and reduced the number of
tion that may help address complaints, as well.
problems relating to the
care (Personal improvement,
cont’d next page)
February 2012 Current Nursing in Geriatric Care 9