Dear Senator Maureen Walsh

Subject: Dear Senator Maureen Walsh
From: Healthcare Mike
Date: 22 Apr 2019

Senator Walsh,

I hope this Easter message finds you well. This message comes to you from far outside of your district, and I understand you're likely to not read this message due to that reason, but I hope that you do. My family and I were dismayed last week to hear your comments characterizing a subset of nurses in rural hospitals may perhaps have some more opportunities to take rest breaks than nurses in more urban areas. I can understand your assumption perhaps never having been a healthcare worker yourself. My wife and I are and have both been healthcare workers working 12+hr shifts for many years. I also perhaps understand you may want to treat this negative publicity by turning the cheek and offering some solutions to our overburdened (and increasingly so) healthcare system. I have a suggestion. Modify the HCAHAPS requirement for Medicare reimbursing.

My observation is this. Currently hospitals are required to conduct "satisfaction surveys" for hospital visits to ensure that patients are taken care of. However, as you may know, most people aren't feeling very pleased or happy during a hospital stay. Usually they get bad news or something bad may have happened to them that caused them to wind up in need of a serious hospital visit. Also, some individuals utilize hospitals as recreation drug facilities or otherwise abuse the healthcare system to procure medical treatment or abuse medications. In some cases these patients are referred to as "frequent flyers". In some cases these patients are utilizing hospitals for psychiatric issues, others for drug use, etc. Other times patients are just not happy after a hospital stay. Sometimes one interaction between a hospital employee throws off the patients entire hospital experience. Should this affect the ability of a hospital to afford caring for patients in need of treatment? How does that affect how hospitals treat all patients? How does that affect hospital employees? I can share with you my theory and my experience as well as my suggestion. Do not allow satisfaction surveys to determine how well professional clinicians can utilize their training and expertise. Because right now HCHAPS do affect everything from how critical a doctor can be with a patient who can make changes in their life to affect their health to how often patients get seen by nurses, etc. Right now, with HCAHPS, hospitals have become more customer service based than clinical/caring healthcare facilities. I feel this also contributes to the opiate epidemic. Doctors and nurses are forced to think more about how happy or pain-free the patients are than how their illness can be resolved or managed. We respond to call bells more than careplans and that allows for the most vocal and obnoxious of patients to be prioritized over those patients who suffer in silence. I beg you to ask nurses if this is true. I can guarantee the surveys of healthcare professionals will echo my statements. I have seen patients die in pain while frequent flyers on the same nursing floor have had nurses wait on them hand and foot primarily due to the customer service directives dictated by HCHAPS and responsive medicare reimbursement.

My suggestion

Instead of "Satisfaction surveys" regulate independent, certified and critiqued chart audits. Reward tough-talking Healthcare professionals who address real needs with better access to resources. Reward quality measures scores. All of these are better options than asking patients to compare their hospital visit to their coffee shop trip. I can bet that you would receive astounding support from the healthcare professional community and nurses would thank you for understanding them.

This is my humble hope that you could use this opportunity to make measurable changes to the healthcare culture and profession. This is an excellent opportunity.

I thank you kindly for your time and consideration,

-Michael xxxxx
Former Certified Nursing Assistant and husband of an amazing Registered Nurse (who has never played cards at work)