Improve Your HCAHPS Scores with GREAT Communication

Effective communication is absolutely critical to a positive, loyalty-building patient experience. And when the patient experience is great, your HCAHPS scores are likely to follow. But remember, the patient experience is really about more than getting great scores—it’s about delivering great care that will earn you the top scores. We use the acronym GREAT to help coach and counsel healthcare organizations on how to boost not only scores but organize optimal encounters with patients and family members.

Learning and applying GREAT communication skills helps not only in clinical encounters but in a variety of non-clinical encounters as well. It’s about communication between anybody and patients. Anybody who comes into contact with a patient can follow this simple formula to increase chances of creating an excellent encounter:

• G is for greet. An appropriate greeting is one that includes the patient’s name whenever possible. It’s delivered with direct eye contact, a friendly smile, and a personal introduction. Be positive and engaging to ensure that you create a positive first impression. Example: “Good morning, Ms. Baird. My name is Kris and I will be your nurse today.”
• R is for relate or recap. You relate by finding ways to make personal connections with patients, recapping something that you know about them or their care. For instance: “I understand from Sheila, the night nurse, that you’ve been having trouble sleeping.” This recap not only helps you connect with the patient but also conveys a clear signal that you are part of an entire team dedicated to ensuring a positive care experience for the patient. You are demonstrating that her care has been a point of discussion between you and the night nurse.
• E is for explain. While the delivery of healthcare may be very familiar to you, it is often foreign territory to your patients. It is helpful to be very explicit about what you are doing, what will happen next, and what patients can expect from their experiences with you. This step helps to manage expectations and quell fears. It’s also a great time to refresh the whiteboard in the room as you post the day’s activities and explain the whiteboard’s use as a communication tool. Explain your role and what you are there to do.
• A is for ask. Ask open-ended questions to gain an understanding of the patient’s understanding, needs, and concerns. Avoid questions like: “Do you have any questions for me?” It’s too easy for the patient to respond “No,” and all too often that is exactly what they’ll do. Instead, ask, “What questions can I answer for you right now?” By asking this way, the patient is more likely to open up.
• T is for tell and thank. Tell patients what they can expect next and how they can reach you if needed. Thank patients.

Here is a scenario to show how this technique is used for a non-clinical encounter. In this case, a maintenance worker has been contacted to fix the thermostat:
• G—“Good afternoon, Mr. Jenson. My name is Ty and I’m from the maintenance department.”
• R—“I see from this request that you’re having some trouble controlling the temperature in your room. I’m sorry about that.”
• E—“I’m here to fix the problem (explanation). It should only take me about five minutes (manage expectations).”
• A—“Is this a good time for me to work on the thermostat?” (After completing the task) “It looks like it’s working now. Is there anything else I can do for you?”
• T—“Your room temperature should be back to normal shortly. If you need any further assistance with it, please call me at this number and I’ll return to make the adjustment. Thank you.”

I have written about this process in my book, Raising the Bar on Service Excellence, where I give additional examples. I have also found it to be very helpful as an additional tool in service recovery situations.

The GREAT communication process can be used in any setting from the simple office visit to an emergency room encounter. It provides a way to effectively connect with the patient in a way that positively impacts perceptions of the overall care experience—and that’s a great thing for you, your patient, and your healthcare organization.

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