January 3, 2008, 11:43 am

Hey Corporate Know-It-All, What Do You Recommend?

salhepatica

Well, blow my nose!

The key to fighting a cold is a laxative!

Instead of cleansing the nasal passages, you cleanse the intestinal tract!

And, you combat acidity!

Apparently, the acidic life is not worth living.

Up with alkalinity! Get up wit’ yo’ bad pH!

This is false advertising, anyway.

The husband is waiting on the wife? Yeah, right. In the Twilight Zone, maybe.

Sal Hepatica. Sounds like salty liver.

And to think, I thought Afrin was my best friend when I was sick!

******************************

Press Ganey.

I’ll wait until you get over your nausea.

Okay….take a deep breath…..

I thought I’d check out their website and I found this blurb:

How do patients size up your health care environment? Find out with Press Ganey’s Patient Satisfaction Surveys and discover how to target your improvement efforts where they matter most.

Target improvement efforts where they matter most.

Well, what does matter most to patients who visit the ER?

Based on what I’ve read in various “questionnaires”, it seems there is only one real complaint:

  • Patients don’t like to wait.

For anything.

Let’s use “rooming” as an example.

They want to go to a room on arrival, therefore we are now required to perform “immediate bedding”.

For everyone.

And lord forbid that we take them to the triage room first and then put them in a room.

That doesn’t count. Then we hear at the staff meeting that the doctors don’t think we are bedding immediately enough.

After all, there was a bed open!

And somebody had to……tell me it isn’t true……….actually wait for a few minutes before being escorted back to the treatment area.

Oh, the horror!

******

Call me crazy, but we are an ER.

Geeze, we’re one of the (if not THE) premier heart facility in the damn state and now they are trying to make us a stroke center, both of which require emergent, as in FREAKIN’ STAT! implementation of specific protocols.

Wouldn’t it be prudent to leave a monitored bed available for these extremely serious patients?

Just one?

No.

Tis nobler in the mind to suffer the slings and arrows of frantically moving patients in an emergency than to keep someone waiting.

Press Ganey is not pleased when patients wait.

And when Press Ganey is not happy…

Well then it must be the nurses’ fault.

Right?

8 Comments


  • ERnursey

    January 3, 2008 at 12:30 pm

    Oh Press Ganey, barf. I wish we could go back to being an ’emergency’ room and not the frickin patient satisfaction center.



  • ERMurse

    January 3, 2008 at 6:37 pm

    Provider is Triage, Zero Wait ED’s, Triage Bypass plans, Immediate Bedding, or whatever the trendy term is tend to get rid of an effective Triage system and once beds are full +1 then there is frequently not an effective way to safetly priortize patients because Triage has been eliminated and the staff are assigned elsewhere. Then the system of prioritizing falls back to first come first serve with higher acuity patients in low acuity areas and low acuity patients in high acuity areas. The ED becomes a confused mess just so non-urgent patients do not have to wait. And its all about the low acuity patient, the ones who get surveyed, that is driving this process. The higher acuity patients are excluded in most cases because they either get admitted, transfered, or dont survive to fill out a survey. There is a good article coming out in the Jan 2008 Annuals of Emergency Medicine that should shed some light on this, its titled, Customer Satisfaction Versus Patient Safety: Have We Lost Our Way. Good read for all ED staff



  • Candy

    January 4, 2008 at 8:35 am

    In my ideal world, hospitals would solve a lot of this crap by staging EDs and including an urgent care center in the mix. No patients would go anywhere without being triaged FIRST.

    Emergencies would go to the ED (which would have fewer beds, because hey, a cold is not an emergency) and non-emergencies would go to the urgent care center, which would be open and fully staffed 24 hours a day. They would have more beds, but since the acuity would be lower, staffing ratios would be lower. It could even be used for simple fractures and lower order wounds.

    Because the urgent care and ED would both be staffed by the same ED physician group, the docs could rotate if they wanted, so they’d all get to be Ben Casey instead of Marcus Welby once in a while.

    Nurses would cross-train, but could enter the rarified world of ED by starting in the urgent care center. Reimbursements would be the same for both areas, because they are now anyway — both would be bad, but because fewer resources would be used on the non-emergent cases, the write off would be less.

    Press Ganey would not exist in this ideal world, along with all the other “we bought our awards” programs. Just imagine what these hospitals could do with the extra money spent on these programs that don’t prove anything and distract from the real job, which is patient care…



  • Patrick at RNSpeak!

    January 4, 2008 at 3:03 pm

    Have to agree – if Press Ganey ain’t happy – it must be the nurses fault! NOT!

    Love your blog – please add my blog to your blogspehere – that would be awesome. Thanks!



  • AlisonH

    January 4, 2008 at 9:23 pm

    I know! Hire a knitting teacher to come and hand out balls of yarn and offer lessons as needed. Then the patients will want the waits to be longer, so they can finish their row they’re working on!

    And you think I’m kidding. Heh.



  • Shannon

    January 5, 2008 at 1:53 pm

    LOL! I am impressed with how you just expressed my thoughts exactly!!! We are fighting the Press Ganey war at my hospital and our term is “bedside triage.” Glad (well not really) to see we are not the only ones with these issues!

    My new favorite is when the neurosurgery team keeps accepting ICU patients from other hospitals even though the ICU is full. Where do you send that patient? Have them board in the ED – of course! ED nurses are critical care nurses – no matter that they each have 6 other patients also! Someone, other than the ED charge nurse who apparently doesn’t matter, needs to tell these people NO!



  • Dawn

    January 6, 2008 at 11:49 am

    Our hospital won the Press Ganey award two years running and is now working on getting a third and it’s making my life freaking miserable. The “customer” is ALWAYS right and I was actually scolded last week for asking the girlfriend of a patient to quit tugging on the PICC line dressing and was told that each and every person who walks into our hospital is to be treated as if they just rented a room at the Hilton…literally my nurse managers words.



  • El

    January 8, 2008 at 1:26 pm

    I resigned from a hospital that uses Press Ganey for their patient satisfaction surveys because the monthly survey results for the ER were always in the lowest percentile even though I know I and my coworkers did our best to deliver quality nursing care. The tongue lashings our nurse manager would give us in staff or private meetings would make you think our nursing care was equivalent to MRSA. P/G perpetuates a “Burger King” mentality in hosptial administrators and the public: your healthcare, your way and in under 2 minutes. To add insult to injury, any bonuses the hospital paid out to their employees was based on the P/G survey results. You can guess what department received the lowest or no bonus. Yep, the ER. But the medical group contracted to deliver ER medical services received very healthy bonuses based off of the same P/G results. Hmmmmmmm?????


About Me

My name is Kim, and I'm a nurse in the San Francisco Bay area. I've been a nurse for 33 years; I graduated in 1978 with my ADN. My experience is predominately Emergency and Critical Care, and I have also worked in Psychiatry and Pediatrics. I made the decision to be a nurse back in 1966 at the age of nine...

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