Susan E. Mazer, Ph.D. Blog

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Hi, and welcome to my blog! I'm Susan E. Mazer -- a knowledge expert and thought leader on how the environment of care impacts the patient experience. Topics I write about include safety, satisfaction, hospital noise, nursing, care at the bedside, and much more. Subscribe below to get email notices so you won't miss any great content.

HCAHPS Survey Questions Not Really About the Patient

June 13, 2014

HCAHPS Questions Not About the PatientBuilding on my post from last week, healthcare providers ask patients lots of questions to find out if caregivers did their jobs right. And, from my own experience as a patient in a hospital last year, I don’t think the main question has never been asked.

In fact, if we lump all the HCAHPS survey questions together, none of them are actually about the patient.

During this hospital stay, how often did doctors treat you with courtesy and respect?

The focus of this question is on the doctor, not the patient. And, providers will never know what happened to generate any particular answer.

Also, someone can treat you with courtesy and some kind of respect and still not give any indication that they actually care about what happens to you.

That was my experience. On the one hand, being in the hospital is never voluntary and staying the hospital is even less so. On the other hand, making it clear that what happens to the patient matters — not just the outcome — is rare.

Then, to make it worse, follow-up calls are made by people who never met you and don’t know anything about you.

Nurses care by practice and tradition. Physicians care when they start, but the caring is “sciences” out of them. Then, over time, nurses become more medicalized, responding to a dehumanized system.

Patients and families adjust to their behavior, thinking, “It is what it is.” However, everyone loses.

The healing relationship is one that bonds patients and caregiver — where both experience a transformative relationship that is glued together by the goal of healing.  A caring moment happens when the magic of the human connection becomes obvious to both parties.

Dr. Jean Watson speaks of it in her 10 Caritas Processes, the first of which calls caregivers to “embrace altruistic values and practice loving kindness with self and others.” If caregivers do this, there is never a question that what happens to them matters to someone else. They are in it together with their patients.

Empathy, caring, and compassion require that we admit our own vulnerability in order to be close to another.  In treating an ill patient, the healing occurs first in the mind and spirit when the connection, one heart to another, is palpable.

Coming back to the HCAHPS survey questions, the “how often” is meaningless.  “Courtesy and respect” are seriously not enough. And, the main question has never been asked:

Do you think that what happened to you during your hospitalization mattered to those who took care of you?”

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