FAH Hospital Policy Blog

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Quality & Safety | HCAHPS Survey | FAH Policy Blog Team

Demonstration: Strengthening and Improving HCAHPS Patient Experience Surveying

Today, Bill McInturff and Micah Roberts, Partners at Public Opinion Strategies, are unveiling a groundbreaking report demonstrating how the HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) patient experience survey can be recast and improved.

The report, sponsored by the Federation of American Hospitals, concludes that, even though the HCAHPS survey has a solid track record, it can be strengthened to better reflect changing patient care and varying patient social backgrounds and medical literacy.

The demonstration also found that an online option to administer the survey can work well for many patients and likely increase response rates.

“Patient experience is critically important to improving hospital care. We need an HCAHPS that evolves with the advances in treatment we’ve seen within the past decade. We need an HCAHPS that is relevant to all types of patients – regardless of background or their social determinants of health. It’s time to take the HCAHPS online and modernize it to fit the lives of today’s patients,” said Chip Kahn, FAH President and CEO.

“The demonstration worked very well online and we hope that the results of the survey will help lead CMS and others to say that there’s every indication that an online option should be considered as one of the ways to administer the survey,” said Bill McInturff, Partner at Public Opinion Strategies. “I hope that in a small way, this project opened the door about further strengthening and improving the HCAHPS product.”

The demonstration builds on the study FAH and four other hospital associations released last week, Modernizing the HCAHPS Survey: Recommendations from Patient Experience Leaders. Researchers found that response rates to the HCAHPS survey are falling and that after ten years in the field, it needs a refresh. Recommendations include, among others, adding a digital modality and shortening the survey. The report can be found here.

The demonstration conducted by Public Opinion Strategies tested those key findings. It found that by adding items important to patients, the HCAHPS survey would better measure patient experience.

Some of the measures that could be improved from the current HCAHPS survey include:

The importance of doctors and nurses to listen, show courtesy and show respect.
Experiences that were reported more frequently than existing measures being used.
Chief among these – efficiency of care is a leading experiential factor that drives perceptions about hospitals.
Wait times in general, wait times for discharge specifically and understanding reasons for wait times overall during the care experience are important factors driving hospital ratings and recommendation likelihood.

FAH worked with Public Opinion Strategies to update the survey. This revised survey was administered to 500 recently hospitalized adults nationwide and it accomplished the following:

It better captured experience, reducing the number of experience questions from 20 to 18.
It was administered online in only 8.5 minutes, a statistically significant 1.3 minutes less than the HCAHPS survey.
It was even stronger than the current HCAHPS survey in predicting satisfaction with hospital stay and recommendation of the hospital to friends and family.

In concert with FAH’s report and McInturff’s study, the Federation’s “Hospitals In Focus” podcast released two new episodes focused on the HCAHPS survey. The first episode features Dr. Claudia Salzberg, FAH’s VP of Quality discussing the newly released study examining the HCAHPS survey from the perspective of Patient Experience Leaders. That episode can be found by clicking here. The second episode of the podcast features a discussion between Chip Kahn and Bill McInturff about the findings of his demonstration. That podcast can be found by clicking here.

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