The power of feedback

In an increasingly competitive long-term care environment, measuring resident satisfaction has become more important than ever, industry observers say. Fueled by an empowered and motivated consumer base, the drive to hold healthcare providers more accountable for the services they provide is pressuring the industry to deliver concrete, quantifiable results.

“Resident satisfaction is growing more important by the day because the new marketplace demands it on several fronts,” says Chip Kessler, general manager for Extended Care Products. “To begin with, there’s the increased competition for new residents, not only among nursing facilities in the same region, but with assisted living facilities and the growing presence of home healthcare. As a result, what a nursing facility provides in the way of care and services and specifically how well they provide these things is now more important than ever.”

One of the most powerful forces in the consumer world is word of mouth, Kessler says, adding that people are more vocal about a negative experience than a positive one.

“If a family member has a bad experience, he or she is more likely to talk about it,” he says.

The “still-constant threat of litigation facing our nation’s nursing facilities” is another factor behind the rising importance of resident satisfaction, Kessler notes.

“There is still a very thriving industry of trial attorneys out there which are poised to sue a nursing home with little or no provocation, let alone what a facility does or doesn’t do to meet a resident’s or family’s satisfaction,” Kessler says.

Consumers — particularly the baby boomers — have gained more leverage in demanding a high value for their money, says Mike Mutka, president and COO of Silverchair Learning Systems. Consequently, “there has been a corresponding increase in product lines, such as CCRCs, assisted living and independent living to meet these expectations.”

Online connections
Moreover, a proliferation of information technology has made data sharing readily available, which consumers look for on various Internet sites.

“Personally, I’m not a big fan of gaining resident satisfaction information via the Internet because you are depending too much on the family having to take the initiative and do it,” Kessler says. “And if the family is forced to take this route, more often than not they’ll be motivated to reply because they have an issue or issues with the care the facility is providing.

“Don’t get me wrong, facilities want and need this information, but what may be lacking is families that convey to the facility the many positive things that are being done. For staff morale and the facility’s overall health and well-being, it’s still vitally important to hear the good news as well as knowing the bad,” Kessler says.

While long-term care facilities are recognizing the growing necessity and value of measuring resident satisfaction, the tools being used are still largely archaic, Mutka says.

Two-step process
“Too often, providers use traditional paper-based methods with low response rates and infrequent surveying, usually annually or quarterly, so they don’t get rapid, real-time feedback from surveys,” he says. “Providers will typically look for technology to improve the quality and efficiency of satisfaction measurement, but it’s still not a good formal way to proactively manage relationships with residents and their families.”

To be sure, “new satisfaction measuring tools are critical to the success of long-term care facilities,” says Tracy Humble, RN, vice president of care services for The Compliance Store. Yet gathering information is just the first step, she says, because facilities must also take action to make improvements in the areas where residents are dissatisfied.

“If there is resistance toward the use of these measuring tools to make positive changes, the use of the tool and any effective change will be short-lived,” she says. “On the other hand, our current environment is one of significant flux and change. Although most facilities are willing to attempt new methods of measuring satisfaction and improving methods within the facility to promote satisfaction, it may be difficult for some providers to embrace new methods wholeheartedly. In other words, not all new methods being attempted now will be as successful as facilities would want or as successful as the attempts might be if undertaken in a less variable climate.”

Among the goals Humble recommends for providers: Begin a way to formally and informally gather information; develop a protocol for addressing areas of concern; and use the information to make positive changes in residents’ lives.

“These goals should allow residents to live a dignified, enhanced life experience in a supportive environment that promotes positive resident outcomes to the extent it is medically possible,” she says. “When positive outcomes are no longer feasible, the environment should be as individually respectful and compassionate as possible for the end-of-life transition.”

Direct feedback

Although high-tech methods of gathering and reporting data are at the center of the resident satisfaction movement, Kessler says new media should not replace personal connections.

“Nothing beats good old-fashioned face-to-face, one-on-one communication with residents and families,” he says. “Some may scoff at this in today’s high-tech world of the Internet and various other communication techniques, such as texting, Facebook, Twitter and Internet surveys where you don’t have to speak to a person directly. But I firmly believe that personal contact is best. As someone who has worked with several nursing facilities over the last 10 years, I can tell you from first-hand experience that it’s the facilities that emphasize personal customer service and personal interaction with families and residents that are going to be successful.”

Humble adds that providers need to sort through which technology will give them the best satisfaction benchmark data while preserving a close dialogue with their constituents.

“Any information is valuable information, however it is obtained,” she says. “And as an industry, we would be remiss to discard what we know how to do best, which is to build lasting relationships with our residents, families and staff.”

Satisfaction goals
Ultimately, long-term care providers need to determine what level of consumer satisfaction is sufficient for maintaining a positive image in the public eye, raising their level of competitiveness in the marketplace and validating a high standard of service in the healthcare industry, sources agree.

Even those with reasonable satisfaction scores must realize they need to go the extra mile. Mutka advises providers rise above complacency and strive for excellence in serving their residents.

“Satisfaction is not good enough — it provides no security because a satisfied client will leave you for something better,” he says. “The standard needs to be customer delight — overwhelming them with what you provide so that they feel so special and would never consider any alternative to your service. Relying on government-generated satisfaction measures is not good enough — you must think like a hospitality provider, and get your employees to do the same.”

To Kessler, the key is balancing reasonable resident and family expectations with a proactive course of action.
“The resident and family must be educated at the admissions process about certain things like falls and bed sores that may occur at the facility, just as they do at home,” he says. “These things can happen despite a facility’s best efforts and when such an occurrence develops, it doesn’t mean the provider isn’t doing the job properly.

Conversely, the facility must strive to offer the best care and services it can so that the residents and families are satisfied with the effort. This balance is only achieved when the provider is proactive and offers a strong presentation on the realities of life in a nursing home, coupled with the staff’s desire to meet the needs of those they serve.”

The true purpose of resident satisfaction measurement, Humble says, is to enhance the lives of those in long-term care.

“It gives voice, value and autonomy to our residents,” she says. “We as an industry have a responsibility that our residents receive the best care and service possible, no matter what the barriers may be. Resident satisfaction programs are one clear way that we can be diligent in monitoring our service and staying on track by making consistent improvements.”