Quint Studer: Using HCAHPS to Drive Patient Satisfaction

HCAHPS, or the Hospital Consumer Assessment of Healthcare Providers and Systems, is a standardized survey tool used to measure adult inpatient perception of the quality of care they receive at a given hospital. Developed by CMS and the Agency for Healthcare Research and Quality in response to the lack of a national standard for collecting and reporting patient satisfaction information, the survey includes 27 standardized questions, 18 of which assess critical aspects of the patient experience, such as communication, responsiveness of staff, pain management and quietness and cleanliness of environment.

While most hospitals have been required to submit HCAHPS results in order to receive full Medicare payment updates since 2007, not all hospitals are using this data to its full potential, and there is currently no penalty for negative results, says Quint Studer, founder of the Studer Group. He says this tool offers valuable information to help hospitals benchmark and improve not only their patient satisfaction but also their quality. At the same time, HCAHPS' public reporting of data (available at www.hospitalcompare.hhs.gov) will empower more and more consumers to select hospitals based on proven results, making it even more challenging for hospitals satisfied with status quo scores to attract new patients.

Measures quality components of patient satisfaction

HCAHPS differs from previous patient satisfaction tools by asking questions addressing hospital quality and clinical outcomes, not just the guest relations aspect of satisfaction, says Mr. Studer. While courteousness of staff is important, true patient experience ratings need to reflect the quality of care they receive, he says.

HCAHPS also measures frequency, which gives hospitals a better idea of their performance against certain measures. Each question includes an "always, usually, sometimes, never" response, which more accurately reflects how often an important event actually happened and helps organizations identify gaps in hardwired processes such as responding in a timely manner, says Mr. Studer.

Sample questions addressing quality include "How often did the staff explain what a new medication was for?" and "Was written health information provided upon discharge?"

More accurate benchmarking
Before HCAHPS, hospitals could only compare their patient satisfaction rankings to the rankings of the hospitals within their own measurement company's database. Each measurement company asked slightly different questions, making comparisons among databases difficult.

"For the first time, the hospital industry has a way to compare ratings that will create an even playing field for all hospitals," says Mr. Studer. "Now, with the same questions evaluating all hospitals, we can truly compare all patient experiences for all hospitals."

With the ability to compare ratings among all hospitals, hospital leaders will be able to gain a better understanding of how they truly stack up against other facilities, says Mr. Studer. A wider comparison base will also make it easier to identify the best of the best hospitals for patient experience. Other hospital leaders can then reach out to these facilities to learn best practices and bring those ideas to their facilities, he says.

Cost savings
HCAHPS can also provide cost savings to hospitals. In the past, hospitals paid for access to a database of similar hospitals from which to benchmark themselves, paying more for access to larger databases, says Mr. Studer. Now, inpatient satisfaction data from all hospitals is available free of charge, though many hospitals still use measurement companies to survey patients, analyze HCAHPS scores and determine unit-specific scores.

One hospital Mr. Studer works with realized $40,000 in annual savings from using HCAHPS to measure inpatient satisfaction thereby reducing duplicate questions. Large systems can further realize savings by becoming certified to carry out their own HCAHPS surveys and analysis, says Mr. Studer.

Publicly available data
As consumer awareness of healthcare costs and quality grows, more potential patients are expected to visit comparison sites like www.hospitalcompare.hhs.gov, which allow them to compare hospital performance on process of care and outcome of care measures, and now patient experience measures. Hospitals scoring highly in these areas will likely attract more patients as these tools become more popular, which could improve these hospitals' bottom lines as well.

Assist hospital leaders in reaching goals
HCAHPS can also help hospital leaders reach hospital goals. "There isn't a hospital CEO in the country that doesn't want their patients to experience a responsive staff, good communication with doctors and nurses and appropriate pain management," says Mr. Studer. "HCAHPS now give CEOs a very good framework to evaluate how their organization does this compared with every one else in the country."

Quint Studer is a recognized leader and change agent in the healthcare industry and has more than 20 years of healthcare experience. Learn more about Studer Group.

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