Improving employee morale through a discharge callback program

Emphasis on Improving HCAHPS Scores
Hospital administration is quite aware that the emphasis on improving patient satisfaction scores has increased year after year.

Since its inception in 2008, the Consumer Assessment for Healthcare Provider and Systems (HCAHPS) survey, a standardized survey for hospitals that captures patient responses on the care provided, has now become a standard agenda item for every department meeting, ranging from quality, nursing, finance and even human resources. Managers review responses for patients regarding nursing communication, call button response times, communication about their medications, how their pain was managed, and whether or not they received written instructions at discharge.
As one begins to evaluate each of these components, it is clear to see what human resource directors have known all along; which is, without an engaged and highly valued staff, any action plan or initiative designed to improve HCAHPS scores is doomed to fail. Joint Commission released a study from 2005 stating there is a strong correlation between engaged employees and the hospital improving their HCAHPS scores.1 Health leaders supported the fact that motivated staff lead to improved HCAHPS scores, stating that hospitals really "can't do one without the other".2

The Challenge to Motivate and Engage Staff
The challenge for human resourced is finding new ways to engage their staff and interact with them on a continual basis. " Chester Elton and Adrian Gostick, authors of the book The Carrot Principle, insist that the only way to maintain highly satisfied and engaged employees is with frequent and consistent recognition. This is easier said than done. Elton and Gostick point to a number of barriers in the past that have prevented organizations from providing this much needed recognition to their staff. These include; cost, inconsistency and an overall lack of time, documentation as well as a lack of information. Hospital leadership's newest challenge is addressing each of these barriers while trying to minimize the cost and time needed to implement a recognition system. Before administration considers new and costly programs or software to solve this dilemma, hospitals should look inward to evaluate if these needs can be met with current resources.

Using Current Resources
With the tremendous focus the Center for Medicare and Medicaid Services (CMS) is placing on care transition recently, hospitals have already started, or are in the process of implementing a post-discharge callback, or Preventative Care, program for their organization. This allows hospitals to receive timely and informative feedback regarding the patient's stay within 24 to 48 hours and begin immediate service recovery. Items reviewed with the patient may address a number of areas such as; whether or not the patient's symptoms have worsened, determine their compliance with medication regime, confirm if they have made a follow up to their primary care physician, or if they would like to leave any special comments or feedback. Again, before looking elsewhere, hospitals should consider using current programs, such as a clinical discharge callback program, to assist human resources.
Approximately 85-90% of patients who participate in this survey leave some type of feedback or special recognition for staff members that cared for them during their stay. This may include nurses, physicians, aids, and dietary staff or specifically name an individual. This information can be tracked and made readily available for reporting on a regular basis. This gives managers a tremendous opportunity to provide timely feedback and comments from their patients recognizing the staff. This type of recognition would be especially beneficial during one-on-one coaching sessions, in department meetings and even during their annual evaluation.

Carrot or Stick Approach?
Unfortunately, along with the ability to use this tool for positive reinforcement, the program may be also be considered more of a 'stick' approach should the conditions require it. A manager that has documentation they can refer to that displays "Nurse Jane" has had numerous complaints, does add additional weight and credence should any punitive measures be considered. However; just as Elton and Gostick prefer to focus more on positive reinforcement, we will continue to focus more on the carrot approach and how Nurse Jane can receive feedback and complimentary comments regarding the care she gave her patients. In the end, how human resources chooses to use this information is at their discretion.

Addressing Employee Recognition Barriers
Utilizing a post-discharge callback program for human resources addresses a number of barriers previously identified that prevented hospitals from providing consistent and meaningful staff recognition.


If the hospital does not currently have a discharge callback, or Preventative Care program, they may consider using one that can be easily adapted by the managers and used in several departments. The program must also be flexible and easy to implement within the organization. With today's younger work force, emphasizing their importance to the organization and providing meaningful feedback is more important than ever. It is also prudent that these organizations use the resources readily available to them before bringing in additional staff or training to address these new challenges.

About the author: Jay Bishop has over 20 years' experience working in healthcare and has been the COO at J. L. Morgan & Associates since 2015. For over 15 years, J. L. Morgan has been a trusted leader in providing healthcare research providing telephone surveys for over two hundred hospitals nationwide. J. L. Morgan is a CMS CAHPS® certified vendor whose goal is to provide their clients, regardless of size, with a statistically sound, cost-effective method of determining, tracking and bench marking all necessary healthcare data. For more information, please visit

1 Joint Commission – 2005 Correlation between patient satisfaction and engaged employees


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