Nurse workflow, Gen Z enter the patient experience spotlight

Patient experience measures are showing signs of rebounding after falling dramatically during the pandemic, and a few elements are entering the spotlight after having notable effects on hospital scores.

Leapfrog's spring safety grade update, released May 1, shows the first signs of improvement in these measures since COVID-19, though figures are still down from prepandemic levels, the organization said. The composite measures for staff responsiveness and communication about medicines fell the most in Leapfrog's spring 2022 update, with average HCAHPS scores in those categories decreasing by 2.21 and 2.43 points, respectively. The latest data shows these measures ticked up by 0.16 and 0.23 points, respectively, at hospitals between fall 2023 and spring 2024.

An increased focus on nurse satisfaction and workflow could be contributing to the increase in scores.  

A recent study found hospitals can improve HCAHPS scores by investing in the nursing work environment, nurse education and staff levels. The study, published in Medical Care, analyzed HCAHPS scores for 540 hospitals in California, Florida, New Jersey and Pennsylvania in 2016. Researchers found the most strongly related factor to ratings was the work environment. For each standard-deviation increase in work environment score, hospitals were 2.42 times more likely to be in a higher patient experience performance category. Within the work environment category, staff development and continuing education, as well as nurse participation in hospital affairs, appeared to have the greatest impact on scores.

The frequency of nurse rounding can also significantly affect hospitals' patient experience performance, with hourly nurse rounding linked to a 19.4-point increase in hospitals' "likelihood to recommend score" as measured by HCAHPS. Nearly 82% of patients were likely to recommend their hospital when nurses rounded every hour. This figure fell to 73.2% when nurses rounded every two hours and just 41.8% when nurses rounded only a couple of times.

Patient experience is also shifting as the younger generations enter adulthood and begin taking over healthcare decisions for children and aging parents.

Generation Z and millennial patients have far less brand loyalty and significantly higher expectations for fast, convenient care compared to previous generations, Press Ganey found in a June 26 report. More Gen Z patients are making their own healthcare decisions as they enter adulthood. Meanwhile, millennial patients are managing healthcare not only for themselves but also for their children and aging parents.

Scores also vary by specialty. Press Ganey found the specialties with the highest patient experience scores in 2023 were cardiac surgery (79.3%), obstetrics (76.7%), obstetrics/gynecology (75.9%), neurosurgery (75.9%) and orthopedics (75.5%). The specialties with the lowest scores were medical telemetry (63.8%), medical (64.4%), telemetry (65.4%) and trauma (65.8%).

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