Beyond HCAHPS, Patient Surveys Dig Into Functional Outcomes

Cheryl Clark, for HealthLeaders Media , May 17, 2012

To level the playing field at least somewhat, the NIH "wanted to develop a standard way of asking about pain, depression, physical and social functioning and fatigue that could be used in all NIH sponsored clinical trials," Keller says.

Cheryl Damberg, Rand senior researcher and quality measurement specialist in Santa Monica, acknowledges that the pace has quickened to make these functional outcome assessments ready for prime time.

"Five or six years ago, you would barely hear people mention it," she says. "But I think with the work going on at the level of the Office of National Coordinator and meaningful use, and various value-based purchasing measures, people are very focused on outcomes measures now. And providers themselves are saying 'that's the stuff we should be tracking.' "

In the meantime, Damberg says, people are really working hard at an operational level to build tools that ask the right questions" building a tool that takes us beyond patient perceptions of their care, and HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems).

Please don't get me wrong. I think the HCAHPS are important. We want to know that when a patient pressed the call button, help came quickly. It's right that these answers account for 30% of the score to determine a provider's value-based purchasing incentive payment.

But we all know these so-called "hospitality" questions don't really tell us whether the patient got the right tests and diagnosis, the right medications and wound care, the right treatments and follow-up that optimized his or her chance of being healthier after their stay than before. We don't really know if the care that providers delivered actually worked for the patient after they were discharged.  We just know that the service was great, or it wasn't.

We need reassurance that providers aren't just going through the motions, but are actually improving quality.  Let's hope that functional outcome scoring tools are developed, tested and implemented in a way that answers these questions in a way that hastens improvement of care. 

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Comments are moderated. Please be patient.

3 comments on "Beyond HCAHPS, Patient Surveys Dig Into Functional Outcomes"

abiola olagoke (5/23/2012 at 2:56 PM)
Realising that the patient is the goal of any treatment modality, these measures being put in place are really welcome. Thanks for sharing this. I hope those of us in developing countries get to that point too where we make provider hospitals more responsible to patients and patients can say more about treatment modality outcome

Anthony_Cirillo_32556 (5/21/2012 at 8:33 PM)
Having just returned from the Assisted Living of America's annual conference, resident acuity, partnering with hospitals and positioning the industry as a transitional care provider were hot topics. This is great if providers actually collaborate and cooperate. However, there is still much silo thinking that abounds. Actual quality of life outcomes are important to measure. And outcomes will only be aided by an industry working together. I also look at this laundry list of additional reporting and wonder how providers and particularly front line staff will be able to actually care for patients and chart all of this for the bean-counters, regulators and watchdogs.

Kristin Baird, RN, BSN, MHA (5/17/2012 at 2:00 PM)
Cheryl, Thanks for another great article. This is such an important topic and once more validates the need for more consistent, high quality post-discharge follow up.




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