October 2000 405

More on customer surveys run amokDear Editor:

I read your article on “Health care customer satis-faction surveys still running amok” (2000;26:174-7)and was so uplifted by it. It is wonderful to have elo-quent, respected people writing logically and con-cisely about the demoralizing effects on staff of “pa-tient satisfaction.” The article was photocopied andposted everywhere in my department. This businessof being beaten over the head with patient satisfac-tion “scores” must stop, and well-written articles likeyours help. Thank you so much for being in our cor-ner.—Molly Kehr, RN, BSN, CEN, Staff Nurse, Emer-gency and Trauma Center, Memorial Hospital ofSouth Bend, South Bend, Ind

18/64/110594doi:10.1067/men.2000.110594

Dear Editor:I would like to express my disagreement with the

article by P.G. Zimmermann bashing customer satis-faction surveys (2000;26:174-7). I am unclear as towhy Ms Zimmermann perceives these surveys as apersonal attack on nurses, particularly because mostof these tools examine numerous other services andprocesses beyond nursing.

One reason given by Ms Zimmermann for dislik-ing customer satisfaction surveys is that survey toolshave flaws. She states that results must be inaccuratebecause most respondents must be too stressed,blaming, senile, or biased to respond fairly. By its na-ture, the emergency department serves a populationin crisis. However, this is inadequate justification forsummarily dismissing the opinions of those who walkthrough our doors.

She complains that “patients judge ED staff bytheir service skills and not their professional skills.”Even so, the lesson is not to discount the survey, but

to focus on what is important to our patients whilecontinuing to measure professional skills by addition-al means, such as competencies and audits. Perhapsinstead of complaining that the public’s perception ofa “good nurse” is one with good customer serviceskills, nurses could take the opportunity to educatepatients and families about the highly skilled carethat is the hallmark of the emergency nurse.

The author argues that “only about a third (of pa-tients) actually use (health care satisfaction survey)information to make a decision in choosing a healthcare plan.” A third of one’s customer base is a hugepercentage! Why discount them?

According to the author, managed care networks,businesses, physicians, and internal departments areour TRUE customers…the patients are not. Regard-ing these other customers, she asks, “Is happinessTHEIR criterion?” Actually…it is! Satisfied customersgenerally are happy customers, whether they are ra-diologists or a central service department or healthmaintenance organizations. Furthermore, accordingto this “logic,” all attempts to please the end con-sumer (the patient) may be scrapped, because theyare not our true customers anyway.

The author correctly states that no customer sat-isfaction measurement tool is perfect; no measure-ment tool is. This is an inadequate excuse to abandonall attempts to monitor and improve service.

I see an enormous red flag in this attempt to per-suade nurses that patient satisfaction surveys are avicious personal attack, rather than an opportunity toimprove patient care.

Should I or someone I love become ill, I want toreceive treatment from a registered nurse who notonly possesses technical excellence but who will nottell me that concern for my satisfaction “is actuallydegrading to nursing.”—Sharon K. Braun, RN, MN,CEN, Assistant Nurse Manager, Cedars-Sinai Emer-gency Department, Los Angeles, Calif

18/64/110592doi:10.1067/men.2000.110592

J Emerg Nurs 2000;26:405-9.Copyright © 2000 by the Emergency Nurses Association.0099-1767/2000 $12.00 + 0

LettersLetters to the Editor are encouraged and welcomed. All lettersmust be typed double-spaced and should be sent on disk toKaren Halm, PO Box 489, Downers Grove, IL 60515 or via E-mail to: khalm@ena.org