Bridging the Gap

Module 3


Healthcare Service Excellence Strategies


Today hospitals are focused on actively engaging in and assessing service excellence as a strategy to improve care, enhance market share and meet regulatory and/or accreditation guidelines. The role of the nurse as a trusted professional is increasingly recognized for its importance in meeting this service excellence goal. Hospitals and other healthcare settings are shifting their processes to ensure a person-centered approach. This includes a service orientation that is in tune with and responds to the needs of the consumer. Providing satisfying and meaningful care requires strategies that take the individual into consideration and can vary to meet the needs of every unique situation. Creating a high performing service excellence culture can also positively impact an organizations bottom line. High patient satisfaction scores are a barometer of performance. To ensure service excellence in every encounter many organizations have turned to standardized strategies that have been shown to improve communication, satisfaction and quality of care. In this unit a number of these strategies will be introduced.


By the end of this module the learner will be able to:

  • Evaluate various service excellence communication strategies to determine how they impact patient satisfaction, quality outcomes and reimbursement.
  • Make use of one of the common service excellence communication strategies.
  • Describe how communication strategies can improve patient outcomes and nurse satisfaction.
Content Outline
  1. Patient Engagement and Quality Outcomes
  2. Evidence-based Organizational Strategies to Improve Service Excellence and Quality
  3. Communication Strategies
    1. AIDET
    2. KWAKT
    3. Managing up
  4. Rounding Strategies
    1. Purposeful Rounding
    2. Bedside handoff
    3. Leadership rounding
  5. Outcomes of PFCC and Service Excellence
    1. Improvement in Quality Measures
      1. Reduction in length of stay
      2. Reduction in readmissions
      3. Reduction in near misses and errors
      4. Decrease in hand-off errors
      5. Increased safety
      6. Reduction in costs
      7. Reimbursement incentives
    2. Increased satisfaction
      1. Increase in patient satisfaction
      2. Increased nurse satisfaction and retention
Links to Differentiated Essential Competencies
  1. Member of the profession
    1. Assume responsibility and accountability for the quality of nursing care provided to patients, families and communities.
    2. Promote the practice of professional nursing through leadership activities and advocacy.
  2. Provider of Patient Centered Care
    1. Synthesize comprehensive assessment data to identify problems, formulate goals/outcomes, and develop plans of care for patients, families, populations, and communities using information from evidencebased practice and published research in collaboration with the above groups and the interdisciplinary health care team.
    2. Provide safe, compassionate, comprehensive nursing care to patients, families, populations, and communities through a broad array of health care services.
    3. Implement the plan of care for patients, families, populations, and communities within legal, ethical, and regulatory parameters and in consideration of disease prevention, wellness, and promotion of healthy lifestyles.
  3. Coordinate human, information, and material management resources in providing care for patients, families and communities.
  4. Member of the Healthcare Team
    1. Coordinate, collaborate, and communicate with patients, families, populations, communities, and the interdisciplinary health care team to plan, deliver, and evaluate care.
    2. Serve as a healthcare advocate in monitor and promoting quality and access to health care for patients, families, populations and communities.
Links to Texas Concept Based Curriculum

Concepts Psychosocial

  • Diversity
  • Interpersonal Relationships

Concepts Professional

  • Communication
  • Professionalism
  • Teamwork and collaboration

Concepts Health Care System

  • Healthcare Organizations
  • Leadership and Management
  • Patient Centered Care
  • Quality Improvement
  • Safety

Communication Strategies

Bedside Reporting

Hourly Rounding

Service Excellence

  • Allen, T., Rieck, T. and Salsbury, S. (2016). Patient perceptions of an AIDET and hourly rounding program in a community hospital: Results of a qualitative study. Patient Experience Journal, 3(1), 42-49. Retrieved from
  • Carman, K.L., Dardess, P., Maurer, M., Sofaer, S., Adams, K., Bechtel, C. and Sweeney, J. (2013). Patient and family engagement: A framework for understanding the elements and developing interventions and policies. Health Affairs, 32(2), 223-231. doi: 10.1377/hlthaff.2012.1133 Retrieved from
  • Collier, M. & Basham, L.M. (2015). Patient engagement: Happy patients, healthy margins. Accenture. Retrieved from (
  • Crotts, J. C., Dickson, D. & Ford, R. (2005). Aligning organizational processes with mission: The case of service excellence. Academy of Management Executive, 19(3), 54–68.
  • Deitrick, L.M., Baker, K., Paxton, H., Flore, M. and Swavely, D. (2012). Hourly rounding: Challenges with implementation of an evidence-based process. Journal of Nursing Care Quality, 27(1), 13-19.
  • Dempsey. C., Reilly, B. and Buhlman, N. (2014). Improving the patient experience: Real-world strategies for engaging nurses. Journal of Nursing Administration, 44(3), 142-151.
  • Johnston, Robert (2004). Towards a better understanding of service excellence. Managing Service Quality, 14(2/3), 129–133.
  • Kenargy, J., Berwick, D. & Shore, M. (1999). Service quality in health care. Journal of the American Medical Association, 281(7), 661–665.
  • Leighty, J. (2006). Hourly rounding dims call lights. American Journal of Nursing, Retrieved from
  • Leitch, J. (2016). What matters to me – a new vital sign. TEDxGlasgow. Retrieved from
  • Meade, Christine M. et al. (2006). Effects on nursing rounds on patients' call light use, satisfaction, and safety. American Journal of Nursing, 106 (9), 60.
  • Press Ganey (2015). Nursing Special Report: The Influence of Nurse Work Environment on Patient, Payment and Nurse Outcomes in Acute Care settings.
  • Rawlins, M. (1999). In pursuit of quality: The National Institute for Clinical Excellence. Lancet, 353, 1079-1082.
  • Robert Wood Johnson Foundation (2013). Health policy brief: Patient engagement, Health Affairs, Retrieved from
  • Studer, Q., Robinson, B.C. and Cook, K. (2010). The HCAHPS handbook: Hardwire your hospital for pay-for-performance success. Gulf Breeze, FL: Fire Starter Publishing.
Discussion Questions

What service excellence strategies have you observed in the clinical setting?

Where these interventions applied consistently?

Have you seen a difference in situations where one of the communications strategies was used and one where it was not used?