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Quiet At Night
1) Since the only reference patients have for “Quiet at Night” is how quiet it is in their own bed at home, caregivers should educate patients to understand:
That the sounds they hear are due to the efficient delivery of care in our hospital.
That we do everything we can to minimize noise so patients can rest.
That we do everything possible to eliminate interruptions to their sleep.
All of the above.
2) By actual decibel measurement, the loudest noises on any clinical floor are produced by:
Nurses and physicians during a shift change.
Family and friends while visiting.
Doors being shut.
The overhead pager.
3) Your hospital’s own version of a “Hushhh Campaign” can do wonders in increasing noise awareness and lowering noise volumes. It would be built around:
A recognized physical gesture between all associates that signals “Please lower your voice”.
Dimming hall lights during afternoon ‘rest periods’ and at 9:00 p.m. as an immediate sign of “Quiet Time”.
Posters and other graphics in hallways to remind all staff and visitors of the need for quiet.
All of the above.
4) The greatest assistance toward a quieter floor will come from:
Clinicians speaking in whispers.
Ban talking between 8PM and 8AM.
Renewed awareness of noise levels at shift change.
Asking visitors to monitor their own voice levels.
5) Here are tips for changing behaviors toward a quieter floor. One among them is counter-productive. Which is it?
Telling the group about how a fellow staff member messed up.
Empower all staff with a License to Silence.
Semi-annual recognition to the team member who best embodies the vision of a healing, peaceful environment.
Including stories of quiet behaviors by staffers in weekly service excellence meetings.
6) The behaviors needed by leaders of a “quiet” campaign include all but one of these:
Consistency in checking scores for “quiet,” sharing results, and leading the quest for improvement.
The ability to request changed behaviors from anyone not adhering to the hospital’s ‘quiet’ guidelines.
Talks the talk but is unable to role-model the repertoire of behaviors he advocates.
Skills to confront anyone who fails to keep faith with those standards.
7) Re-framing patients’ perception of a clinical floor from “too noisy” requires which of these strategies?
Re-educate to inform these as ‘sounds of care’ which must go on so others can heal as well.
If feasible, eliminate night wake-ups for ‘vitals’.
Re-frame so patients understand a hospital floor will never be as quiet as their own bedroom at home, and as long as they still healing, they are safer here.
All of the above.
8) Frontline staff members are empowered to do all but one of these:
Request any local noise to cease (a floor-waxer in front of room where a patient desperately needs rest).
Report any mechanical noise to supervisor or directly to engineering department, for repair.
Send another staffer home for the day if he’s too noisy.
Politely ask a physician to aid the “Hush Campaign”, by lowering his voice.
9) Best behaviors for ‘quiet’ can be taught and learned by everybody. Identify a strategy that doesn't work, below:
Peer-to-peer workshops.
Overly long lectures on the subject from the HR Department.
Managers and leaders who visibly model the way, daily.
Physicians who set good examples.
10) Family visitors can be enlisted in the ‘quiet’ campaign by:
Giving them a card that lists visiting hours and expectations for quiet.
Praising them for keeping their voices low.
Asking them for suggestions for a quieter floor.
All of the above.
Cleanliness Of Patient Rooms
11) A study of hospitals revealed what percent of healthcare workers fail to maintain good hand hygiene?
5%
26%
60%
95%
12) The person who can report an unclean bathroom (anywhere in the hospital) to Housekeeping is:
A manager.
A nurse.
Another housekeeper.
Anyone who sees it.
13) Cleanliness and hygiene issues produced by the patient require immediate care. These include:
An unclean bathroom.
Soiled bed linen or gowns.
Evidence of blood stains or other body fluids, especially those out of sight, i.e., under beds or nightstands.
All of the above.
14) Care-givers’ uniforms / scrubs / lab coats should be fresh daily. If soiled in the course of a work-day:
Remember to get fresh issue next day.
Freshen the soiled garment with Febreze.
Change that garment immediately.
Exchange the soiled garment with a co-worker who has less patient contact.
15) Nurses, Aides, and other clinicians can best help Environmental Services personnel by:
Waiting until EVS arrives to clean up all spills, etc.
Believing that “We’re all housekeepers!” and we can keep rooms clean as we make our rounds.
Allowing EVS supervisors to report unclean rooms.
Leaving overflowing room trash cans for EVS to change.
16) Managers can gain staff’s buy-in to best practices for eliminating HAI’s by promoting all but one of these:
Communicate expectations and set reachable goals.
Engage staff by listening to and empowering their best ideas.
Tell them what to do without allowing any questions.
Clear any roadblocks to their cleanliness plan.
17) To maximize your unit’s disinfection regimen, pay attention to such high-risk surfaces as:
Telephones and tv remotes.
Everything in the room that anyone may come in contact with.
Faucets.
Door handles.
18) This is an issue of your personal responsibility, beyond the scope of the EVS team: be alert to frequent daily cleaning of equipment and material you use on more than one patient:
Stethoscopes, IV pumps and poles, glucometers.
Computer keyboards, computers on wheels.
Blood pressure cuffs.
All of the above.
19) At the 2011 SHMD Conference in Phoenix, attendees were asked to rate the four top patient fears. Infection was one of the four. Where did it rank?
First
Second
Third
Fourth
20) Requiring our constant vigilance, the routes by which infection is transmitted in a hospital are:
Air-borne (via contaminated air-conditioning system).
Contact (hands, clothing, catheters) or via self (bowel surgery).
Food-borne (kitchen insects, rodents), or blood-borne (needle sticks).
All of the above.
Communication About Medicines
21) What percent of ALL prescribing errors that occur in a hospital result from incomplete medication histories at the time of admission?
2%
27%
48%
77%
22) When educating a patient about new medications it’s most important to:
Clear the room of all guests and family members.
Make sure the patient is fully awake.
Have the main at-home care-giver present and sitting next to you.
Give the patient your phone number for questions, post-discharge.
23) When instructing about new medications, what words are most effective when making patients aware of potential adverse outcomes:
“Side effects” (patients need the HCAHPS survey wording) .
“Things to watch out for are….”.
“Be aware of these things happening from taking this drug…”.
“Uncomfortable results of taking this drug might be…”.
24) The best strategy for working with family caregivers who are confused about a loved one’s new meds --- but reluctant to reveal their uncertainty is:
Repeat the information several times so they understand it.
Give them print-outs describing the medication and side effects.
Politely ask caregiver to repeat back and “teach back” you what they’ve learned about the medication. Re-teach as necessary.
Hope you’ve been clear, and that they’ve picked-up on what’s important.
25) An effective way to discern likely patient compliance with his medication regimens is:
Ask him.
Be alert to lack of interest in the medication information being given, and a similar lack of curiosity and commitment from family caregivers.
Ask close-ended questions to ensure compliance: “Now, you’ll take these meds as directed, every day, right?”.
Assume everyone knows that taking medications as directed is important.
26) The Institute for Healthcare Improvement advocates medication reconciliation at which of these transition points:
At admitting (understand which meds are currently taken).
When transferring a patient to other units or to o.p. settings.
At discharge (reconcile new meds against what’s at home, inform which old meds are to be discontinued, thrown away).
All of the above.
27) It’s vital to educate patients about what every new medication they receive is intended to do because:
They need to tell their pharmacist when they renew the prescription.
They need to understand the importance of this medication to their recovery and continued good health.
They can explain to their physician why they don’t need it.
They can tell if the medication is doing its job.
28) The best way to start a conversation with patients who are reluctant to ask questions about their medications, is to say:
“Sometimes, patients are curious about how this medicine…”.
“Many patients wonder about…
“I’ve had patients express concern about… Do you feel that way?
All of the above.
29) Pharmacists making regular rounds are most needed:
To make patients feel an expert is at hand.
To check on medication supplies in a unit.
To educate patients taking sophisticated medications, or who have complex medical issues.
To answer nurses’ questions.
30) Creating an environment where all clinical personnel can respectfully question a physician on prescribed dosages requires:
Formal policies which empower/indemnify RN’s to question MD’s prescriptions/dosages, on the spot, as warranted.
Nurses with extensive pharmaceutical training.
Managers ready to intervene if a physician feels his authority is threatened.
Proper written forms to be filled out by RN, and sent to CMO.
Communication With Doctors
31) Doctors have many ways to demonstrate their interest in patients as people, but the foremost behavior to build a therapeutic relationship is to:
Listen actively, and allow patient to talk.
Ask about their pets.
Explain diagnosis really, really slowly.
Play games with family members.
32) JCAHO reports that over 60% of sentinel events can be attributed, at least in part, to poor communication. Whether with patients or support staff, as a physician, what can you do to ensure that you are understood?
Never assume patients/staff have an easy acquaintance with numbers and percentages. Check for correct understanding.
When connecting with others, don’t rely on the referred power/authority of your title and your white coat.
To ensure you are understood, reflect back patient or staffer’s response and ask “Do I have that right?”.
All of the above.
33) Four relational styles for physicians. Which one is least likely to be successful in providing generative care for a patient?
Informative Physician - informs, patient selects.
Interpretive Physician - selects after eliciting patient’s values.
Paternalistic Physician - knows best.
Deliberative Physician and Patient – select together after consideration of values.
34) As a physician, if you get reliable survey feedback that your “people-skills” are less than effective, you can change your behavior by:
Simply being more aware of how you affect others.
Engaging a gifted colleague or a professional to coach you.
Reading a book on better bedside manners.
Relaxing in the knowledge that “people-skills” do not a great diagnostician make.
35) To help patients understand the context of the care you will provide, “orienting comments” are essential. Which behavior fails to “orient” a patient:
Describing the examination you will do.
Explaining the tests you will order and when the results will be in.
No outline for the plan of care.
Explaining how the hospital works.
36) Studies have shown that surgeons who’ve never been sued spent how many minutes longer with each patient than did those who have been sued?
3 minutes
7 minutes
15 minutes
Number of minutes don't matter
37) With patients reluctant to ask questions of you as physician, you can reliably start a productive conversation by asking:
“So, what questions do you have for me?”.
“Many times, patients are confused about…Do you have any of those concerns that I can help you with?”.
“I’m here to answer your questions, so fire away…”.
“We still have a couple of minutes…any questions?”.
38) Gladwell in Blink, writes: “But in the end, malpractice comes down to a matter of respect, and the simplest way that respect is communicated is through tone of voice, and the most corrosive tone of voice that a doctor can assume is a dominant tone.” To correct a dominant tone in your voice:
Hire a vocal coach or voice therapist.
Record yourself singing.
Experiment altering to a more violent tone.
Practice yelling.
39) Being a physician allows you to enter into a ‘privileged intimacy’ with another human being. You get there by tuning into:
A patient’s individuality.
His emotional and cultural dimensions.
What he is enduring, to deduce what he needs.
All of the above.
40) “Active Listening” employs verbal encouragement to a patient, as in “Tell me more…” or, “And then what happened?” or, “Sounds like it was a very scary time for you…” Which activity below is not “active listening?”
Head nods.
Physician totally occupied with charting in his laptop.
Leaning forward in your chair to hear better.
Eyebrows raised to indicate interest.
Communication With Nurses
41) Beyond their clinical responsibilities, Nurses, Aides, and other bedside caregivers can provide most comfort to patients by:
Making sure they have their personal items close at hand.
Being acutely responsive to the patient’s spoken and unspoken emotional needs.
Offering to refresh their water or choice of beverage.
Directly asking patient if he/she is comfortable.
42) What’s the wisdom in implementing bedside reporting at shift change?
Integrates patient into the care team.
Promotes safer patient hand-off’s.
Builds patient and caregiver trust.
All of the above.
43) We advocate having a chair or moveable stool in every patient room. It allows caregivers to sit and chat with a patient for a moment. Time seated vs. time standing also creates the perception of a longer visit. Five minutes seated feels like __________ to a patient?
7 minutes
9 minutes
10 minutes
15 minutes
44) When patients first get into their hospital room, they are apt to feel anxious, frightened at the new surroundings, cut off from home and family. Clinicians can seize this moment:
To use patient’s fears to get them to pay attention.
To make patients feel welcome, their best expectations fulfilled.
To ensure patients do as they are told.
To make sure patients are docile during their stay.
45) S.E.R.V.E. is a reliable model for connecting with patients, introducing yourself, and explaining how you’ll work together. It validates a patient’s expectations and concerns in every area except which one?
Explains the clinical work to be done.
Outlines the estimated time it will take.
Promises a pain-free outcome and a quick recovery.
Pays attention to patient’s anxiety.
46) Here are communication imperatives for nurses. All but one are okay:
The ability to get patients to laugh at their problems.
Courtesy and Respect.
Mindful Listening.
Empathy for all patient challenges.
47) When dealing with a difficult or angry patient, all but one of these behaviors will prove helpful. Can you spot the ineffective strategy?
Acknowledge the angry patient’s distress.
Understanding them is absolutely key; fake it if necessary.
Put them in control by offering choices, alternative solutions.
Make things fair; level the playing field.
48) When patients are suffering, self-esteem often gets lost. Which of these positive statements build up patient’s esteem?
“How do you manage to cope so well…?”.
“What helps you most to get through the day…?”.
“What supports or strengths do you rely on…?”.
All of the above.
49) Patients yearn for compassion and kindness, faith and hope. Nurses look to comfort…
Loss of control.
Anxiety.
Loss of interest in media.
Vulnerability.
50) Nurses’ courtesy and respect builds patient relationships. All but one of these behaviors exemplifies this professional demeanor:
Knock and ask permission before entering patient’s room.
Build a relationship quickly by calling patients by first names.
Request permission before moving/handling any of a patient’s possessions.
Honor the patient’s report of what’s going on in her body --- however strange --- as valid for the patient in that moment.
Discharge & Transition Of Care
51) A hospital administrator said: “It’s not the re-admissions that are the problem --- it’s the avoidable re-admissions!” What percent of readmissions are avoidable?
48%
59%
65%
75%
52) The most important work in preparing a patient for discharge is:
“Independence readiness:” educating patient / family to transition from dependency on hospital support to thriving independently once home.
Making sure they get in the habit of taking their meds as directed.
Close coordination with case worker re: a smooth discharge.
Reminding patient to make follow-up appointments with MD’s.
53) Which one of these questions does not appear on the HCAHPS survey for “Transition of Care”?
The hospital took my preferences and those of my family into account in deciding what my healthcare needs would be when I left the hospital.
When I left the hospital, I had a good understanding of the things I as responsible for in managing my health.
The hospital was aware that I received a new diagnosis mid-way in my stay. They were sensitive to the possibility of overwhelm, and worked to help me understand it, over time.
When I left the hospital, I clearly understood the purpose of taking each of my medications.
54) About one in five patients suffer an adverse event during the care transition period, i.e., once out of the hospital. What is the most common adverse situation?
Wrong diet once home or in new healthcare facility.
Readmission caused by being “too active too soon”.
A medication-related event.
Neglect by at-home caregivers.
55) One of the ways to assess risks confronting a patient before discharge, is to be aware of ‘polypharmacy.’ The word means:
A patient seeking drugs.
A patient on five or more meds, and whose adherence is apt to decline.
A patient conversant with the drug-compounding process.
A patient who uses more than one pharmacy to fill his prescriptions and thus is at risk for missing regular dosages.
56) Well-informed caregivers know that a key to a healthy recovery is teaching patient and family to be active participants in the self-management of their healing. This process ideally starts when?
A few hours before leaving the hospital.
With a very complete take-home binder at check-out, containing all the relevant information.
During visits from the case worker or social worker.
As soon as the new patient is safely in a bed. It continues daily with RN’s, CNA’s and MD’s, right up to discharge or transfer.
57) “Teach back” and “Show back” ensure understanding of meds and self-care at home. But if you heard a caregiver checking for safety this way before discharge, you would be very upset:
“I want to make sure you have a good understanding of the adverse signs and symptoms to watch for at home. Will you tell me what they are for both of your new medications??
“So, someone told you about your new meds, right? …and you don’t have any questions, do you…?”.
“Please explain to me in your own words what I taught you about your new medication. I want to be sure you’re safe…”.
“So that I’m sure you know how to change your dressing…will you please show me how you’ll remove and replace it…?”.
58) Having an NP or an RN as a “Transition Coach” is a boon for older patients because:
Can make home visit within 72 hours. Is a solid, single point of contact.
On further follow-up visits, can coach / role-play strategies to avoid adverse events leading to re-admission.
Can assess for risks, see things possibly missed when in hospital.
All of the above.
59) To avoid re-hospitalizations, it’s advantageous to forge good partnerships with the nursing homes to whom you routinely send patients. The single element you most want to establish is that:
The skilled nursing facility has superior physician and mid-level staff to assist in preventing re-hospitalization.
They make a great first impression to insure family and patient satisfaction.
They are decent about receiving all necessary patient information at admission.
They meet regularly with your hospital system to develop strategies.
60) In the matter of who’s in charge of the patient when transitioning out of the hospital, the Primary Care Physician is often the best choice because?
PCP’s generally know patient and family best.
They are aware of patient’s progress during his stay.
Lack of PCP involvement is a big part of early re-admissions.
Can best answer questions about managing healthcare post-discharge.
Pain Care
61) What’s the best strategy for helping patients manage pain?
Inform them ahead of time about what to expect.
Reassure patients that some pain is normal, post-operatively.
Explain that pain can’t always be eliminated, but that you’ll be with them to help them cope and control it.
All of the above.
62) According to a study by the Institute of Medicine, what percentage of patients remain in moderate-to-severe pain because of clinician’s failure to reassess and intervene?
27%
39%
50%
64%
63) If pain is “the fifth vital sign,” how often do we make a pain assessment?
On every visit to the bedside, every peek into the room.
At the patient’s request.
At hourly rounding.
At bedside report / change of shift.
64) The many “myths” about taking medication for pain include the mistaken notions that meds cause addiction, over-sedation, or that pain is inevitable and must be ‘toughed out.’ Clinicians should:
Respect any and all folkways about the dangers in pain meds.
Use their knowledge to address and refute misconceptions about pain medication.
Endorse the right thinking of patients who believe they “deserve’ their pain.
Support those who resist pain meds “until I really need them…”.
65) What essential pain coping skills need be taught to patients?
Acceptance. Go from “Why me?” to “What to do now?”.
Balance. Tortoise vs. Hare. You know who wins.
Calming. Breath techniques, meditation, distraction.
All of the above.
66) Which is not a proven way to stay ahead of the pain curve:
Commit to patient that you will always return to administer pain meds on time
Commit you will return to reassess, 30-45 minutes after giving the medication.
Remind patients to ask for pain medication 30-45 minutes before moving from bed for therapy, for a shower, or to walk in the hallway.
Write date and time of next pain dosage on white board.
67) In addition to spending extra time with the most vulnerable pain populations (the elderly, those with cognitive impairments) we need to most importantly be aware of
Those with a history of abuse, neglect, and little social support.
Those with poor economical status.
Small children.
Any other people with minimal pain challenges.
68) To help children three years and older tell about their pain, what multidimensional assessment is likely to be most effective?
A zero-to-ten pain scale.
A verbal intensity pain scale.
A Wong-Baker “Faces” chart.
A ‘locate the pain’ body-diagram.
69) If a patient needs more pain meds and his physician is not on duty, the most important thing when calling up in the middle of the night is:
Having an apology ready for waking her up.
Having your SBAR report complete and correct.
Being prepared to tell how much pain the patient is in.
Asking why she didn’t leave discretionary orders for more meds.
70) What is most significant about this classic piece of advice from a senior nurse? “If you don’t manage their expectations, you won’t manage their pain.”
Patients anticipation is often more frightening than the actual pain.
Patients’ mental pictures (expectations) are often more formidable than the experience of pain.
Patients are often not aware of how profoundly their unconscious expectations are influencing their behavior.
Patients have vivid impressions of pain from friends and family who have suffered.
Responsiveness Of Staff
71) To get to the heart of the HCAHPS “Responsiveness” question:
Promise patients you’ll always answer call lights within two minutes.
Use body language that indicates you are always busy and attentive.
Express compassion/sensitivity to patients’ potential for feeling anxiety, isolation, and confusion in hospital environment.
Be diligent in rounding, even if it’s just a quick peek in the room.
72) A successful, hospital-wide effort to engage all staff-members in accepting accountability for being “responsive’ to patients requires:
Leadership by all administrators, managers, and influential frontliners.
Voluntary staff participation in this culture change.
A schedule of occasional meetings to chat about ‘responsiveness’.
An ‘honor system’ by which staff gives themselves stars for being responsive.
73) For ‘responsiveness” to be a uniformly house-wide behavior it must start at Admitting. Which of these expectations need to be set for new patients:
Hourly in-room Rounding.
Patient/family participation in Bedside Reporting.
Timely responses to all call light requests.
All of the above.
74) Being responsive means managing patients’ conscious expectations. These include:
Ease of access (get to see a physician relatively quickly).
Wait times (are reasonable).
Scheduling (the daily routine is well-organized).
All of the above.
75) Patients expect their wait-times for all services to be minimal. What works least successfully in managing wait times?
Eliminate ‘uncertain’ wait-times. Give patient a ‘time certain’.
Let patients wait alone. Time goes faster when patient is solo.
Banish ‘unexplained” waits. Explain. Explain. Explain.
Watch out for ‘unfair’ waits. Keep wait-times equitable.
76) According to the American Journal of Nursing, purposeful hourly rounding by RN’s and nurse assistants returned all but one of these results. Which one?
37% - 38% reduction in call lights per day.
50% - 52% reduction in patient falls.
85% - 87% of patients complained not liking being looked after so regularly.
9 – 12 point increase in patient satisfaction.
77) Bedside report at shift change provides an additional level of responsiveness to patient safety:
Four eyes can better assess for things like pressure ulcers, etc.
Oncoming RN can trace lines, confirm med & rate, verify dose.
With neuro patients, an opportunity to make sure oncoming RN knows exactly what outgoing RN saw, etc.
All of the above.
78) When providing service recovery, it’s essential to ‘join up’ with the person who has a grievance. Which response is out of tune?
I can certainly see why you feel/think/say that...
Yes, it’s a rotten break, and here’s what we can do about it…
It’s not our fault, and we’re sorry you feel this way…
You’re right, it would have been better if it didn’t happen. And here are the steps I’m taking to correct it…
79) Beware the “I’ll be right with you” or the “I’ll be right back” response. It can mean one thing to a patient--and something quite different to the caregiver. Where’s the misstep here:
It’ll take me five minutes to get your bath ready…
Your pain medication is due in 15 minutes. I’ll be with you in 10.
There’s something I need to take care of with another patient. I’ll try to get right back but I don’t know how long it’ll be.
Let me find Dr. Blanchard for you. I know where he is and I can have him here within 30 minutes. Will that be acceptable?
80) If you intend to implement a “No Pass Zone” (with “no walk-by’s!” as its motto) what group of associates seem as though they can be counted out, but should not be?
All non-clinical personnel (engineers, maintenance, dietary and EVS staff).
All Executives and Administrators.
All managers.
All staff and team members.
Overall Rating
81) A reason why “Overall” scores may rank low when all other HCAHPS scores are high is:
Only disgruntled patients answer surveys.
They use this category to retaliate against their hospital.
They know “Overall” is a first place other people look on the HCAHPS website, want to spread their bad news.
They have long memories of service at the hospital: Grandma had a bad experience here years ago, how can it be better now?
82) Since our performance as caregivers is always being watched by patients, the most important thing we can do is:
Wear clean uniforms, look sharp.
Let patients/families know the best tv shows.
Teach our staff to handle patients’ overall concerns via health education, reassurance, empathy - and an apology, if needed.
Show sensitivity by apologizing often.
83) A Press Ganey survey showed the most powerful driver of overall Patient Satisfaction is:
Responsiveness of staff.
New hospital facilities.
Private rooms.
Food on demand.
84) If your hospital wants to exceed the national average for “Overall” satisfaction, the leadership’s action that commands all others is:
A clearly articulated vision and action-plan for the future.
A solid culture focused on patient-centered care.
An engaged and aligned frontline staff.
Consistent accountability to all the above principles.
85) When gathering staff to focus on their “Overall” effort, which call to action will fail to gain followers?
“Here’s where we’re going, and how we’re going to get there.”
“Here’s what I think we ought to try because I just read an article about it on the web, and it might work well for us, too.
“Here’s why I want you to join me…”
“Here’s what I’ll hold you responsible for…”
86) To create a great “Overall” hospital culture, demonstrate timely responsiveness to your annual staff satisfaction survey by
Affirming and improving areas of frontline dissatisfaction.
Coaching any managers with gaps in their leadership skills.
Hardwiring these changes to strengthen and renew staff.
All of the above.
87) “Nothing about me without me” is the motto of today’s engaged patient. Many actions assure this happens, to insure overall satisfaction and healing. Which one, below, doesn’t?
Patient participates in bedside report at shift change.
Patient is offered no other choices (bathing, meals, time alone, etc.).
Physician and RN involve patient in plan of care.
Patient and family engage in choices for after-care.
88) A newly-formed Patient/Family Advisory Council is doomed if it:
Provides information on new services needed for patients.
Becomes a powerful conduit for input from the community.
Is allowed to see its function as a forum for ‘gripe sessions’.
Improves relationships between patients, families, staff.
89) Since 50% of admissions come through the ED, overall appreciation of the hospital increases when the ED runs smoothly via:
An Organization “Unwritten Rules”.
Inter-departmental frustrations ironed-out in well-run meetings.
Agreements for efficiency with all ED’s ancillary departments.
Negative communication between all these clinicians.
90) Given the power of social media to affect overall impressions of service, how could your hospital use what can be gleaned from the ‘net?
Pay attention to timely patient and family comments on the net.
Assign owners to take action, celebrate and spread the good word.
Do service recovery with those who commented unhappily.
Adopt all these ideas as part of your “Overall” strategic plan.
Recommend The Hospital
91) Why does “Willingness to Recommend” trump other HCAHPS survey domains?
It’s the first place people look on the survey.
The most powerful referral a hospital can get.
A summary judgment of how good you are.
All of the above.
92) The one thing a “Willingness to Recommend” is not, is:
An award you can’t earn thru conscious effort; it either happens or not.
Patient’s retrospective view of his total experience.
A subjective comparison to his expectations.
A strong predictor of patient’s likelihood to return.
93) A proven way to earn a “likely to recommend” score is to meet or exceed patient expectations. Of the many ways to do so, which one listed here is not helpful?
Consistent personal attention.
Courtesy and respect.
Over-promising and under-delivering.
Compassionate pain management.
94) A frontline and managerial staff aligned with the hospital’s mission and values will discharge patients ready to “Recommend.” To assure such alignment, eliminate which one of the following:
Quarterly 1:1 conversations with staff regarding shared purpose and direction.
Feedback to staffer on what he’s doing well, and what needs attention.
Coaching to fill the skills-gaps.
A manager who doesn’t want feedback from staff on how he himself can improve.
95) To earn a consistent, positive “Yes” on the “Recommend” question, train your staff to focus on four areas. Which one of these aims for an outstanding patient experience is least important?
Patient comfort (freedom from pain).
Patient “happiness”.
Patient active participation in decisions for care.
Patient education for healing and better health, post-discharge.
96) Amid the welter of misinformation on “The Keys to Win a “Definitely, Yes” there is one nugget of wisdom. Which is it?
Don’t try to anticipate patient needs. It frustrates you, and riles up patient.
Your gut reaction about a new patient will be correct. Go with it.
Be non-judgmental. Avoid misconceptions about people. Rely only on evidence-based information.
The ‘healing power of touch” is New Age nonsense. Stay within yourself.
97) Often, high HCAHPS scores in the eight domains are confounded by low scores in “Recommend.” This happens when patients have long memories of real or imagined service mishaps that may date back for years. To overcome this historic perception of the hospital in the eyes of your community:
Set goals for hospital outreach to influence your city’s health.
Enlist all staff in creating positive buzz everywhere via Health Fairs, Hospital Open House, MD’s and RN’s as Speaker-Educators into schools, senior centers, church groups, etc.
Engage city’s first responders (police, fire, EMT’s) as hospital boosters, and health advocates.
All of the above.
98) In their survey of the Ten Issues Most Highly Correlated with Likelihood of Recommending the Hospital, Press Ganey lists them in rank order. Of these four, which ranked last?
Pleasantness of room decor.
Responses to concerns and complaints.
Staff sensitivity to the inconvenience of health problems and hospitalization.
Degree to which hospital; staff addressed my emotional needs.
99) To stay on top of the behaviors that make patients want to “Recommend” your care, use Erie Chapman’s “Mother Test.” It reminds you to:
Bring your mother to work, let her assess your department’s morale.
Ask yourself: “If my mother was admitted with a serious problem, how confident would I be that she would receive loving service from everyone?”.
Ask your Mom if she would want you for a hospital caregiver.
Enlist your mother to tell all her friends and neighbors about your hospital.
100) The Baby Boomers are the fastest growing segment of the healthcare population. Are you getting ready for them? Which of these do they NOT expect:
To hold health care professionals accountable for quality of care.
Health care professionals to suggest what’s best for them.
To make informed decisions for themselves.
Milk and cookies at bedtime.
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