Healthcare Issues

New Hospital Quality Measure

On March 28, 2008, the Hospital Compare website managed by the Centers for Medicaid & Medicare Services (CMS) added a new section on HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems). HCAHPS (pronounced “H-caps”) is the first national, standardized, publicly reported survey of patients’ perspectives of hospital care. It is a standardized survey which collects data that can be used to measure the hospital experience as perceived by patients.

As stated on the HCAHPS website, www.hcahpsonline.org:

The intent of the HCAHPS initiative is to provide a standardized survey instrument and data collection methodology for measuring patients’ perspectives on hospital care. While many hospitals currently collect information on patients’ satisfaction with care, there is no national standard for collecting or publicly reporting this information that would enable valid comparisons to be made across all hospitals. In order to make “apples to apples” comparisons to support consumer choice, it was necessary to introduce a standard measurement approach. HCAHPS can be viewed as a core set of questions that can be combined with a broader, customized set of hospital-specific items. HCAHPS is meant to complement the data hospitals currently collect to support improvements in internal customer services and quality related activities.

Below are the 10 aggregate questions asked of patients subsequent to being hospitalized. These 10 sets of questions were winnowed from more than 30 sets that were tested in various pilot scenarios and found to be the most reflective of how satisfied patients were in general, as well as with some key aspects of their hospital stays.

  1. How often did nurses communicate well with patients?
  2. How often did doctors communicate well with patients?
  3. How often did patients receive help quickly from hospital staff?
  4. How often was patients’ pain well-controlled?
  5. How often did staff explain about medicines before giving them to patients?
  6. How often were the patients’ rooms and bathrooms kept clean?
  7. How often was the area around patients’ rooms kept quiet at night?
  8. Were patients given information about what to do during their recovery at home?
  9. Would patients recommend the hospital to friends and family?
  10. How do patients rate the hospital overall?

What I mean by aggregate questions is best shown using an example. Take question number one. Three questions actually comprise this one aggregate: During this hospital stay…How often did nurses treat you with courtesy and respect?…How often did nurses listen carefully to you?…How often did nurses explain things in a way you could understand?

The possible set of answers for questions one to nine include: always, usually, sometimes, never. For questions nine and 10, patients’ ratings are based on a scale from zero to 10, where zero means “worst hospital possible” and 10 means “best hospital possible.” Hospitals’ HCAHPS results are posted on the Hospital Compare website, found at hospitalcompare.hhs.gov, or through a link on medicare.gov. CMS has compiled data from nearly 5,000 hospitals and reports both national and state averages to help consumers evaluate just how well their local hospital(s) measure up.

One of the important aspects of this public reporting of data is that consumers can see how well their local hospital(s) have done during the past year or so—because the data is based on a rolling set of 12 months of surveys—as well as seeing improvement in their scores, hopefully. As is noted on the Hospital Compare website, “The goal for each measure is 100 percent.” When you view the findings for the four hospitals in the Greater Peoria Area, you’ll note that we are all above the national and state averages but have room for improvement to reach that goal of 100 percent for each measure. IBI