What leads to high HCAHPS scores? Survey uncovers best practices from high-performing hospitals

Simple practices, like proactive rounds by nurses and hospital leaders alike, are some of the best things hospitals can do to have a positive effect on their patient satisfaction survey scores, according to research out of Johns Hopkins.

Hanan Aboumatar, MD, an assistant professor of medicine at the Baltimore-based Johns Hopkins University School of Medicine and member of the Johns Hopkins Armstrong Institute for Patient Safety and Quality, says most hospitals have made patient experience a priority, but they have taken different routes to get there, to varied results.

"People used different strategies," she says. "There was no formula [and] some did better than others."

To find out what works, Dr. Aboumatar and a team from Johns Hopkins sent surveys and letters to CEOs and clinical staff from 53 hospitals across the nation that were top performers or had recently significantly improved their patient satisfaction scores based on December 2012 HCAHPS survey scores.

The survey responses uncovered several commonalities between the successful hospitals in strategies for patient experience improvement.

Cultural facets

One of the most-reported strategies from respondents involved their organization's culture. A majority — 77 percent — of hospitals reported that a commitment to patients and their families is integrated into their culture, and they attributed their high patient safety scores in part to this mindset.

"The organizations [that] are high-performing were ones [that] did not think of the patient experience as an add-on," Dr. Aboumatar says. "They thought of it as much more integral to the type of mission that they have. [It's] what they're all about."

Operational facets

Beyond building a focus on patient experience into the culture, the importance of staff involvement and engagement in the mission to improve patient experience really stood out to Dr. Aboumatar from the survey's findings.

"The most pleasantly surprising finding is that, for the most part, the [successful] hospitals have created different ways by which to engage all people within the organization in this quest to improve patient experience," she says.

The survey responses showed 83 percent of surveyed hospitals had proactive nurse rounds in place, and 62 percent reported that leaders from all levels of the organization also rounded on patients.

Involvement at the leadership level — which included not only managers but executives and board members — appears to be a key ingredient in the patient experience improvement recipe. Some respondents indicated that leaders blocked out time in their calendars to round on patients and staff, asking patients how their stay is and asking staff what, if anything, they need to help them do their job to the best of their ability, according to Dr. Aboumatar.

Including leaders in rounding is important because it involves people with decision-making power directly in patient experience, she says.

Other best practices reported by the highly rated hospitals included always making eye contact with patients and sitting by the bedside instead of standing over patients.

While the survey did reveal some best practices for providing excellent patient experience, there is one final point from the research that all hospital leaders should take to heart: These strategies can be implemented anywhere.

Similar practices were reported from all different types of hospitals, regardless of bed size, location or teaching hospital status. Additionally, the successful patient experience programs generally did not require high-tech resources and did not have a high cost barrier to implementation.

Or, in Dr. Aboumatar's own words to hospital executives, "You can do it!"

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