APPENDIX A: PATIENT-CENTERED CARE AND HCAHPS
The HCAHPS survey is a nationally standardized survey that captures patients‘ perspectives of their hospital care. It allows consumers, for the first time, to compare hospitals based on measures of how effectively they are satisfying patients‘ needs and expectations. The survey‘s 27 questions look beyond clinical outcomes and technical capabilities of hospitals and focus instead on aspects of the care experience that are particularly meaningful to patients, including:
- Communication with doctors
- Communication with nurses
- Communication about medications
- Responsiveness of hospital staff
- Pain management
- Quality of discharge instructions
- Cleanliness of hospital environment
- Quiet of hospital environment
With hospitals‘ scores publicly reported by the Centers for Medicare and Medicaid Services on its Hospital Compare website (www.hospitalcompare.hhs.gov), accessible by consumers, competitors and media alike, sound performance on these measures is imperative. Indeed, the HCAHPS program has elevated the importance of hospitals paying attention to the patient experience, and consequently, has considerably fueled interest in patient-centered approaches to care.
By definition, patient-centered hospitals look to their patients and their communities to help define a positive and satisfying patient experience. However, while patient responses to HCAHPS survey questions ranging from ―always‖ to ―never‖ happens can provide useful input to hospitals about how well they are meeting patients‘ needs and can draw attention to aspects of care where improvements can be made, these responses alone do not address the full range of things patients and families desire in their interactions. Patient-centered organizations refrain from using changes in HCAHPS scores as the only measure of whether an intervention designed to improve the patient experience was beneficial, and instead combine the HCAHPS data with other qualitative and quantitative information about the patient, family and staff experience.
In this section of the Guide, we turn again to the voices of patients themselves for their insights about their experiences with hospital care. The source of the data that follows is an analysis of more than 90 patient focus groups (representing 645 patient voices) conducted by Planetree Inc. in hospitals across the United States over the course of three years. Patients were asked a series of questions about their hospital experience, including what went well and what could havebeen improved, and many of their comments have appeared elsewhere in this Guide. Whereas HCAHPS scores can tell us where we are satisfying patients‘ needs and where we are falling short, these patient comments shed light on the how, why and what, including how we, as an industry, can better communicate with patients and their family members, what their expectations are with regard to responsiveness, and why the environment of care is such an
important aspect of the care experience.