The Role of Nurses in Improving Patient Experience

Patient experience is an important division to evaluate the medical quality. In the United States, the results of HCAHPS survey will influence the payment of insurance including government Plans such as Medicare and Medicaid. In addition, patients will evaluate hospitals according to their experience on Yelp and comments on that will influence patients’ choices of a hospital. Nurses are those who have most interactions with patients and they play a very important role in patient experience [1].

These years China also started to focus more on improving patient experience. In the past, the relationship between patients and hospitals used to be of tension. Patients required more compassionate care and better experience, but hospitals could not meet the requirements because of traditional ignorance and huge amount of both inpatient and outpatient services. However, during the past several years, with more and more urge for better patient experience [2], hospitals started to make more efforts on improving patient experience. National Health Commission also required hospitals to improve patient experience and patient satisfaction for both inpatient and outpatient service starting 2019 for all tertiary public hospitals.

Chinese government carried out a patient experience questionnaire of which nursing was an important part. In the outpatient experience survey, there are four items directly related to nursing including respects for patients, understandable explanations, privacy protection, and timely response. In the inpatient experience survey, nurses play more important role. There are nine items related to nursing including respect to patients, listening to patients carefully, understandable explanations, timely response to call bell, timely response to calling for help at night, pain control, medication explanation, respect to patient family and discharge guidance [3].

According to the survey of 9.18 million outpatient respondents and 5.36 million inpatient respondents from September, 2017 to December, 2018 based on the data from tertiary and secondary public hospitals in China, in outpatient care, nurses paid more attention to communication with patients and got higher satisfaction scores on this item, but patients were not satisfied with their privacy protection. As for inpatient experience, patients were more satisfied with nurses than doctors, especially with respects to patient family [4].

Improving nursing quality is essential to improve patient experience. A good service system including 10 factors: service requirements, service concept, service goals, service commitment, service language, service behavior, tangible expression of service, service process, service evaluation and service improvement. Improving nursing quality can follow this logic. Among these 10 factors, there are some factors are extremely important to improve patient experience. First is identifying the patients’ needs which are effective, efficient and safe treatments with respect. It means hospital should design a good system so that doctors and nurses are able to provide safe service smoothly and promptly. Second is service language and behavior. They require nurses practicing standard medical operations and using polite and respective language [5]. Third is tangible expression of service which means good environment such as clean and bright ward, obvious sign guidance, drinking water, etc. Fourth is the smoothly service process. Fifth is the service evaluation from three aspects: structure, process and outcome. Hospital managers should set up a series of indicators to evaluate the nursing quality. Finally, the most important part is to improve the nursing quality according to the patient needs and evaluation results.

Communication is an important part of patient experience. Both HCAHPS and Chinese patient experience survey include communication between nurses and patients, as well as doctors and patients: polite and respect, carefully listening, understandable explanation and timely response. Hospital can conduct surveys every month in every department, and then find out which department needs further improvement.

Except communication with patients, communication between nurses is also important. How to explain patients’ status clearly and handover your job to the other nurses is really important because it will affect the continuity and stability of nursing quality, and then influence the patient experience. Therefore, being a friendly communicator with colleagues is important.

Patient experience started to draw more attention in China and nursing quality plays an important role in improving patient experience. To improve patient experience, nursing of good quality is required which is to provide safe, effective and efficient nursing service. In addition, communication with patients and communication between nurses are also important for improving patient experience.

1. National Health Commission of the People's Republic of China (2017) Notice on Printing and Distributing the Action Plan for Further Improvement of Medical Services (2018-2020) (NHCPRC (2017) No. 73).
2. The General Office of the State Council of the People's Republic of China (2019) The General Office of the State Council on the work of strengthening the performance appraisal of tertiary public hospitals (GOSCPRC (2019) No. 4).
3. Zhai Xiaohui, Zhu Shijing, Gao Xuecheng (2019) Analysis of the patient experience in public hospitals in China. Chinese Journal of Hospital administration 35(4): 283-286.
4. Yang Chunshi (2018) Build a good service system and let the hospital really enter the heart of the patient.
5. Yi Hui (2017) Investigation on the current situation of application of nursing sensitivity quality indicator system in a tertiary comprehensive hospital in Xinjiang. Shihezi University, Xinjiang, China.