It seems that everyone is chasing after doctor and hospital ratings. From Revolution Health to Yelp, consumers are encouraged to rate hospitals and physicians in their communities. Hospitals and physicians are the two obvious providers to rate in our healthcare system. However, I think we have left out, the largest and, arguably the most important members of the healthcare profession --- nurses, certified caregivers and home health aides.
Let’s compare the numbers.
Today, there are approximately 4,927 community hospitals and an average of 800,000 licensed physicians in the United States. Comparatively, there are 1.4 million Registered Nurses, 749,000 Licensed Practical Nurses, and 1.8 million certified nursing assistants, home health aides and non-certified caregivers.
That is roughly 4.1 Million members of the healthcare community that we have left out.
All of us have been cared for, in one way or another, by a nurse or nurses’ aide. There is a group of nurses at Strong Memorial Hospital in Rochester, New York, who I credit with saving my brother’s life when he was on a vent in their transplant unit. There is Jacqui, who practically delivered my second daughter. My husband and I still talk about Jacqui whenever we dive into the story of Julianna’s birth with family and friends. She was everything you would want in a caregiver – smart, knowledgeable, easy to talk to, soothing, helpful and kind.
Jacqui and the nurses at Strong Memorial Hospital would have five stars under their profile picture – if there were a way for me to publicly rate them.
I have also had the unfortunate encounter with caregivers who should not be, in my opinion, in the healthcare profession. I left my OB/GYN six months pregnant with my first daughter when his nurse told me I was overreacting to nightly nose bleeds, insomnia and bouts of hysteria. “Your just pregnant, deal with it,” was her advice. In my caregiver review, this nurse would have very few stars.
How is it that the largest segment of healthcare professionals, who provide a majority of the direct, hands-on patient care have been left out of the health 2.0 ratings explosion? These 4.1 million nurses and nurse aides have greater daily contact with patients than anyone else in the hospital, nursing facility or home care setting. They perform clinical procedures, assess patient conditions, and monitor patient stability. They take vitals, change dressings, bathe, feed and turn patients. They communicate with family members and answer questions often with the push of a button. They provide companionship and assistance in the comfort of a patient’s home. They cook, clean and monitor medication intake.
Even though nurses, certified aides and para-professionals provide care to millions of patients annually, consumers have yet to be provided with a tool for rating these caregivers. Although most providers evaluate nursing staff and some are subjected to government regulatory review, they do not actively seek caregiver ratings for all staff. Furthermore, providers operating in the face of a significant nursing shortage, sometimes accept mediocrity in order to maintain compliance with mandated staffing ratios. Private providers even have more leeway in turning a blind eye at poor caregivers in order to keep the doors open and profit margins up.
An open source model for reviewing and rating nursing personnel is desperately needed. Not just for families and patients, but for caregivers as well. Talented caregivers should have a platform for marketing their skills, building a network of referrals and leveraging their abilities in this demanding labor market.
When I built ENURGI, the vision was to empower patients and families in need of home care to connect with local caregivers. We have since built the first, national caregiver database with an open platform for connecting and managing caregivers at home. A key feature of this platform is caregiver ratings. Patients and families can rate their caregivers based on quality, dependability, expertise and punctuality.
Initially, our ratings were open only to ENURGI patients who had actually hired and received care from ENURGI caregivers. The reasoning was that we wanted ratings submitted by patients who could objectively assess the quality of caregivers on the site. Since our launch, families, patients and co-workers across the country have urged us to open the ratings to anyone. Patients sent us emails asking whether they could rate caregivers who previously took care of them. Co-workers who work or worked with ENURGI providers asked to submit ratings on behalf of their colleagues.
The power of an open, caregiver rating system can be illustrated by a recent encounter with someone who did not find her caregiver on ENURGI. Rather, a woman who had recently lost her mom sent an email asking how she could post a profile for the caregiver that had taken care of mom. When I spoke to her, the woman explained that she wanted to help the caregiver find another job because she was one of the most “amazing caregivers” she had met. She emphasized that “anyone searching for someone to help them care for a loved one” should be lucky enough to have this caregiver. “Now that my mom has passed, I want to help her find another job. She is family.”
With that conversation, we decided to open up the ENURGI caregiver ratings. Family, friends, employers, and colleagues can now search on ENURGI and rate a caregiver that they know.
ENURGI is breaking new ground today. All of us should begin acknowledging the largest and perhaps the most important members of the healthcare ecosystem – our nurses, certified home health aides and home care professionals.
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