Comfort, good information top list of customer needs
Providing buffered lidocaine, using blanket warmers, and letting patients know why they are waiting for surgery to begin are just a few of the ways the day surgery staff at Forrest General Hospital keep their patients satisfied.
Patient surveys are mailed to day surgery patients to determine what their expectations were and how well their needs were met, explains Jan Odom, RN, CPAN, FAAN, clinical nurse specialist for the hospital-based and the freestanding day surgery programs operated by the Hattiesburg, MS, hospital.
"Overall, our patients want comfort, information, individualized care, and to be made to feel special." Most often, it is the little things that make a difference, she says. "We discovered that many patients are more afraid of the needle for the IV than they are of the surgery. So, we went to buffered lidocaine to deaden the area of needle insertion. And patients appreciate it so much. We’ve heard that former day-surgery patients who come in for inpatient surgery request buffered lidocaine." Another item added after patient complaints was a blanket warmer, she adds.
Patients also become anxious and rate their experience poorly when their surgery doesn’t start in a timely manner. Using this information from their patient surveys, Odom and the staff kept statistics on surgical start times and reasons for delays.
"Often, the reason for the delay was the surgeon, so we shared the information with them," she says. Although the nurses can’t force a surgeon to start on time, staff now make a point to talk to the patient frequently to let him or her know that there has been a delay and to make sure the patient doesn’t feel forgotten, she explains.
While surveys mailed to patients on a regular basis are a good way to keep track of ongoing satisfaction rates and identify patient needs on an ongoing basis, focus groups are a great tool to use if you are renovating or restructuring your day surgery program, says Diane Fecteau, RN, executive director of Brighton Surgical Services Center in Portland, ME.
When Fecteau’s facility was preparing to renovate the day surgery center, she proposed renovating some of the processes as well. To find out what patients thought was important to a good outpatient surgical visit, she conducted focus groups to get input. Dinner meetings were held at the surgery center, and sandwiches were provided to the participants.
"I held two focus groups of about 12 to 15 people in each group," says Fecteau. The groups were randomly chosen from previous patients as well others who had not had surgery at Brighton Surgical Center. "We made sure we included a variety of ages as well as a representation of different payers," she says.
"In addition to me conducting the group, I had a couple of staff members attend each [session] to make sure they could disseminate the information to other staff members." This extra help in communicating ideas to staff was beneficial. "When changes were proposed, the staff knew the ideas came from the focus groups, not just me," she explains.
Acting on requests from focus group
Focus group members said they wanted a caring staff and a lot of information about what was going to happen before and after surgery, says Fecteau. They also indicated they wanted to be with family members as soon as possible after surgery. For this reason, Fecteau combined the first and second stage of recovery. "One-half of our recovery room is a traditional, open PACU, and one-half has curtained cubicles that allow families to sit with patients," she explains.
Fecteau now relies on patient surveys to provide input about ongoing services and makes changes as needed. For example, when the ratings for level of information given stayed at a 92% level rather than the target goal of 95% satisfaction, Fecteau followed up with phone calls to any patient who gave a fair, poor, or very poor rating on this question.
"I reached 11 of the 14 patients who had given their names and telephone numbers and discovered that the lack of information was on the surgeon’s part, not the day surgery staff’s," she says. "To address the problem, we presented the information to our multidisciplinary physician advisory board and we wrote letters to physicians whose patients raised that complaint."
Efforts have paid off with the June 1999 report showing a satisfaction level of 96%, she adds.
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