Patients Satisfactory Survey – HCAHPS

            Hospitalized Consumer Assessment of Healthcare Providers and Systems or HCAHPS, also known as the CAHPS Hospital Survey was the very first national standardized reported survey that takes into account the perspective of patients when it comes to hospital care. Before, there was no standardized methodology and standard basis for collecting and as well as publicly reporting of surveys or information regarding a patient’s experience in a certain hospital although there had been many hospitals who are collecting such information on their own. Thus, although certain hospitals are already conducting such surveys, there was no valid comparisons that can be made that is acknowledge or set until HCAHPS that is. To have a high rating in the HCAHPS survey indicates that the hospital is doing well in the field of healthcare and in the eyes and points of view of its patients and thus, it reflects how well a certain hospital is doing in providing healthcare to its patients. On the other hand, a low rating indicates that there are some things that must be done by that particular institution since their patients view they efforts and service as lacking and that improvements have to be made.

THE GOAL BEHIND HCAHPS

            It was said that there were three major reasons behind the development and implementation of HCAHPS. First is that, HCAHPS was intended to gather data regarding the perspective care of patients. Thus, allowing meaningful and at the same time objective comparisons of hospitals regarding the matter. Second, HCAHPS was also intended to promote and improve the quality of health care in the country. This effect can be brought through the public reporting of the said survey and thus, allowing hospitals to improve their way of taking care of their patients. Third, it also aims to make the public accountable in health care through the transparency that will be shown by the survey regarding the quality of hospital care in the country. With these goals at hand, steps was taken in order to ensure that the said survey will be credible enough and as well as useful and practical in order to attain these goals and to improve healthcare service in the country.

HCAHPS ORIGIN AND HISTORY

            HCAHPS was made possible through the alliance of the Centers for Medicare and Medicaid Services or CMS and another agency in the field known as the Agency for Healthcare and Quality or AHRO in the beginning of the year 2002. The implementation of the survey in various hospitals was sponsored by an alliance of both public and private organizations from various major hospitals and medical associations, the government, consumer goods, measurement and accrediting bodies and other groups and organizations that are also interested in developing the quality of healthcare in the country also known as the Hospital Quality Alliance or HQA. The National Quality Forum or NQF which is a representation of many consumers and healthcare providers and as well as professionals and other organizations in the field also endorsed the HCAHPS in May 2005 and in December 2005, the final approval regarding the national implementation of HCAHPS for the purpose of public reporting was given by the Office of Management and Budget or OMB. The results and data gather in the HCAHPS are in the public domain together with the methodology of the said survey.

CONTENT AND PROCEDURES

            In order to ensure that the results of the survey can be trusted not only by the public and private sectors in the field but as well as patients who are the most important reason for the implementation of the survey, several questions was made to really assist the preference of the patients when it comes to healthcare. As a result, the HCAHPS survey was composed of 27 questions that relate the patient’s healthcare experience in a particular hospital of healthcare provider. From these 27 questions, 18 are directly related with the patient’s experience in the said hospitals such as responsiveness of the staffs to the patient’s needs, pain management, communication with the faculty and member of the hospitals such as nurses and doctors, cleanliness of the environment, discharge information and as well as the patient’s overall rating of the hospital and the recommendation. Also, 2 of the questions are intended to support congressionally-mandated reports, 3 to adjust for situations wherein there are mix of patients in the said hospital and 4 questions to direct the questions and needs of the patients. These questions had been well-thought to truly assess the perspective of patients when it comes to the service that they achieve and as well as preferences in healthcare.

            The duration for the HCAHPS survey is from 48 hours or 2 days up to 6 weeks after the discharge of the patient from the hospital otherwise, the outpatient will not be able to participate in the said survey. When conducting the HCAPHS survey, participating hospitals have the choice to either collect their own HCAHPS data provided that it was approved by the CMS or to use the approved survey vendor. There are also different modes in which the HCAHPS survey can be implemented in order to accommodate hospitals in the form of mail, telephone, follow-up through mail with telephone or through active interactive voice recognition or the IVR. Hospitals that are participating in the survey also have the choice to either use their own patient satisfactory survey or the HCAHPS itself in integrating the HCAHPS survey.

            Also, CMS takes into account the factors that affect the patient’s answers regarding the survey that may not be directly related to the hospital’s performance by adjusting for these factors in order to ensure that survey scores will be fair and accurate comparisons between hospitals can be made as well. Adjustments had been made by the CMS in order to eliminate certain advantages and disadvantages on the part of the hospitals involved that may be due to the method used in conducting the survey. Data collection is also an important aspect thus; CMS also undertakes activities that include inspection of procedures, data analysis, and as well as site visit of self-administering hospitals and survey vendors approved by the CMS.

NATIONAL IMPLEMENTATION OF PUBLIC REPORTING

            It was on October 2006 that HCAHPS data was collected by the CMS for the public reporting and the results was initially reported in March 200 using the data gathered from patients that were discharged in the hospitals from October 2006 to June of the following year. Afterwards, results of the survey will be published in a quarterly manner that constitute 4 quarters recent of data gather from the survey and the results of hospital’s HCAHPS are also posted on the site of the Hospital Compare.

PUBLICLY REPORTED MEASURES

            There are 10 reported measures regarding the HCAHPS result when it comes to the comparison of the results from different hospitals of which, 2 are individual items, 6 are summaries and 2 are global ratings. The six summary measures include the performance and relationship of the hospital staffs such as doctors, nurses and other member of the hospital and evaluates how well these personnel are able to communicate, interact and provide with the patient’s needs. This may also include the assessment on whether pertinent information was given when the patient was discharged from that particular hospital. The cleanliness and as well quietness of the patient’s room was addressed in the 2 individual measures while the overall rating of the hospital as well as if the patient would recommend the hospital to others was addressed in the 2 global ratings.

THE QUESTION

            After all the effort, time and resources that hade been spent in conducting the survey and publicly reporting the results, the question whether HCAHPS was a success or not still remains. Does it serves its purpose and was really able to help in improving the quality of healthcare in the country? This question remains and only those in the healthcare institutions themselves will be able to tell if these results really do help in order for their institution to develop their service to their patients. In order to asses the effectiveness of the HCAHPS survey; let us examine the performance of a certain hospital, both before and after participating in the survey.

            The New York Community Hospital was founded on 1929 located in Madison Park section of Brooklyn. This hospital took part in the HCAHPS survey and basically had a low rating in the said survey. After seeing the result of the survey, the New York Community Hospital has embarked on an aggressive campaign in order to improve its costumer service. Thus, several actions were made by the management that also includes departmental uniform color coding in which every personnel of every department are mandated to wear specific color in order to be known and recognized by the patients. In the said coding, members of the nursing department are required to wear all white scrubs, blue for the radiology department and green for the respiratory department. The aim of this action is to be able to distinguish every individual from every department like nurses with MD or clerk with radiology and so on and also for the patients to be able recognize anyone from the hospital that provides good or even bad service.

            Another action taken by the hospital was a hospital wide education meeting for eight days during all shifts by the CEO, Lin Mo. The aim of the said education meeting was to highlight the importance of the HCAHPS survey for the future survival of the hospital and thus, motivating the staffs to continue and improve the service given to the patients. If the hospital is not able to improve their rating in the next HCAHPS survey, they are sure to lose more and more patients that may also endanger the hospital as a whole. Thus, by opening this matter to the staffs of the hospital through the said meeting, it is likely that the staffs will be motivated in serving their patients better.

            The third action as part of the hospitals aim to improve the services given to the patients, that will eventually give way to attain higher rating in the HCAHPS survey, was posting signs, media display at the sign in clock and around the hospital reminding the staffs of their on going need to provide excellent service to their patients and to be polite and courteous at all time.

            Another action taken by the hospital in order to develop their service to their patients was to recognize employees in each department who has shown sign of great customer service. These employees will be awarded with either gold silver or bronze medal. By doing so, the staffs will be properly motivated and thus, resulting in a good costumer service that will lift the integrity and name of the hospital.

CONCLUSSION

            By looking at the action that were taken by the New York Community Hospital, it can be said that all the efforts, time and resources used in making the HCAHPS survey possible were not in vain. It does serve its purpose and is really able to improve the healthcare in the country. For any hospital, because of the public reporting of the survey, a good rating will be a motivation to farther improve their customer service and in order to protect the name of the hospital and survey result itself. On the other hand, having a low rating in the HCAHPS survey will also be able to motivate the hospital administration and staffs to also improve their service in order to uplift the name of the hospital and to protect its interest just as in the case of the New York Community Hospital. Thus, it can be concluded that the HCAHPS survey really is a big help in improving the quality of health care in the country.

References

CMS. (No Date). HCAHPS: patient’s perspectives of care survey. Retrieved May 01, 2008 from

            http://www.cms.hhs.gov/hospitalqualityinits/30_hospitalhcahps.asp

Quality Net. (No Date). CAPHS hospital survey (HCAPHS) hospital consumer assessment

providers and systems. Retrieved May 01, 2008 from http://www.qualitynet.org/dcs/ContentServer?cid=1140537251096&pagename=QnetPublic%2FPage%2FQnetTier2&c=Page

hcahpsonline.org.(2008) Centers for Medicare & Medicaid Services, Baltimore, MD. Retrieved

            May 01, 2008 from http://www.hcahpsonline.org

Mo, L. (No Date). Welcome to NYCH. Retrieved May 01, 2008 from

            http://www.nych.com/content.asp?id=13

Professional Research Consultants, Inc. (No Date). History. Retrieved May 01, 2008 from

            http://www.prconline.com/government/hospitals/history/index.asp