Asking the Right Question: Capturing Accurate Patient Family Experience Scores for Ambulatory Care Nurses

As a Magnet organization and an institution that values feedback from families, our organization utilizes a service to survey families after their visits. These surveys ask Likert-type questions with five (5) focused nursing-only questions, with about 5-10 additional questions related to their overall experience with the provider, care team, facility, and system in general. These scores help to drive specific organization initiatives around introductions, care coordination, access, and appointment availability and provide insight to how families are feeling regarding their care. We noted very low scores in our nursing-specific questions across nearly every specialty and location. Concerned that these scores seemed incongruent with the comments, provider scores and general feeling of the teams, leadership and the organization additional investigation was done to ensure accurate data was being captured. During this investigation journey, we noted several opportunities. The first opportunity was that every clinic, regardless of nursing presence, was being surveyed. We were able to remedy this and exclude specific clinics that did not staff nurses from receiving these questions. The second opportunity was with our introductions, specifically with the support team (medical assistants) and nurses. We launched an informal campaign across ambulatory care to encourage introductions of name, role, and then introduction of name and role of the next up team member. This was in an effort to draw awareness to the role of each team member in the visit and enhance the family’s ability to answer accurately related to the nursing components of the visit. Finally, we realized families did not have the option to “opt out” of the nursing questions. This meant that if they did not see a nurse during their particular visit, they were still forced to answer the questions related to interactions with a nurse. We worked with our survey vendor to add a “gate” question that allowed families to skip the questions related to nursing if they did not see a nurse during their visit. At this point, we saw nearly a 20% increase in composite scores across all areas. Families were finally able to accurately report their interactions, and we were able to accurately capture their feedback more closely related to nursing interactions. This was a sustained gain over the course of the year—an additional four (4)-month time frame. Additional work is ongoing, specifically related to continuing to creatively solve how to survey related to ambulatory care-specific work.