Maintaining clinical integrity
Some hospital officials have mixed feelings about patient scoring, noting that sometimes patients seek expensive and unjustified treatment. If those requests are denied, it certainly could undermine patient satisfaction.
"HCAHPS are very difficult to get a grip on," says Alan Kaplan, MD, senior vice president and CMO at Iowa Health System. "You can think of it as an outcome but also a process. There's a trade-off between satisfaction and outcomes. Patients may be a lot happier if I gave them inappropriate antibiotics. And I do believe focusing on patient satisfaction will be increasingly challenging as we manage patient populations and move toward accountable care organizations. I believe it has to be approached with integrity."
For now, hospitals are examining the patient evaluations, one question at a time.
One of the toughest issues for hospitals centers on the question of noise: During this hospital stay, how often was the area around your room quiet at night?
Both the University of Chicago Medicine and Advocate Good Samaritan registered their lowest marks in
Advocate Good Samaritan tallied a patient score of 44%, compared to the national average of 58%, according to HCAHPS.
Fox attributes the low scores to the fact that the hospital, which opened in 1976, has mostly semiprivate rooms. However, he says the organization is taking steps to reduce noise by converting some rooms to private. "In that way, we are going to make a better experience for the family and a more quiet experience for the patients," he says. "We find when patients are complaining about noise, mostly it's from the noise of a roommate or a caregiver coming. We were at a disadvantage because of the semiprivate rooms. We don't use that as an excuse, but we will have a better experience for the patients."
This article appears in the August 2012 issue of HealthLeaders magazine.