Department Focus: Quality--Is HCAHPS Enough?

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For some hospitals, CMS' consumer assessment survey is all they need to measure patient satisfaction. But some organizations want more.

When buying a new car, some people take whatever is on the lot, while others special order a customized version. Such is the case with the Centers for Medicare & Medicaid Services' Hospital Consumer Assessment of Healthcare Providers and Systems survey. The 27 HCAHPS questions cover many of the same subjects that hospitals have queried on their own surveys. But is HCAHPS alone an adequate replacement for customized hospital-designed surveys that are tailored to individual markets? It depends on whom you talk to.

All in one

Patient-centered care is the goal at Griffin Hospital in Derby, CT, a 126-staffed-bed acute-care facility. Griffin was one of the facilities that participated in the HCAHPS pilot in 2004 and began using the tool exclusively in 2006.

"We did very well in the results of HCAHPS at that time, and we moved quickly to adopt the HCAHPS survey as our primary patient satisfaction measurement tool," says Vice President Bill Powanda. "It quickly became our sole patient satisfaction measurement tool."

Griffin administers the HCAHPS survey by phone with the help of Nashville, TN-based market research firm HealthStream. At the end of each phone survey, Griffin has added questions that ask patients about items and actions that go along with the organization's patient-centered mission. "We didn't add many, but we wanted to make sure those that we did add related to the uniqueness of our care model," Powanda says.

Griffin's administration makes sure HCAHPS is on every staff member's radar. Since 2006, results have been posted on whiteboards in patient nursing units, Powanda says, and the hospital has developed an HCAHPS-style survey to measure other areas--such as the emergency room and ambulatory care center.

"We're convinced that HCAHPS is effective and realize that not so far down the road CMS will roll out an ER survey and surveys for other areas," Powanda says. Working with surveys styled after HCAHPS now will only help Griffin down the road, he says.

More data required

At Emory Healthcare in Atlanta, administrators say they appreciate the effectiveness of HCAHPS, but believe that to truly satisfy patients, more information is needed from them. That's why Emory uses more than just HCAHPS to keep track of patient satisfaction, says Redge Hanna, director of service performance for the three-hospital, 1,200-bed system.

"We try to measure everything we do, by looking at what we do and how we do it at the same time. That essence does not always come through in the HCAHPS survey. It doesn't give us comments or the overall perception we're leaving people with," Hanna says.

Emory gets a more complete picture of what's happening at the hospital and can target improvements in different departments when it uses both HCAHPS and survey tools developed by South Bend, IN-based consultants Press Ganey, Hanna says. The tool asks more than just HCAHPS questions and allows the organization to learn about its individual departments and how they are or are not meeting patient needs.

The information gathered from the three survey methods also helps Emory evaluate employees--from its physicians and nurses to its environmental and maintenance staffs. Keeping its pre-HCAHPS survey methods in place provides consistency in employee evaluations, Hanna says.

Last, using Press Ganey's survey and HCAHPS allows for more benchmarking, Hanna says. Emory is able to compare itself to hospitals around the country in areas that HCAHPS doesn't cover. "In school, everyone looks at their grade and then wonders what everyone else got. They want to know, 'How are my peers doing?' Our goal is to get everyone striving to be the best that they possibly can be--individually and as an organization."

-Maureen Larkin

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