The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a standardized survey instrument and data collection methodology used by the Centers for Medicare and Medicaid Services (CMS) to measure patients’ perspectives of hospital care.
While many hospitals collect information on hospital satisfaction, HCAHPS (pronounced “H-Caps”) is the national standard for collecting and publicly reporting information that enables valid comparisons among all hospitals to support consumer choice and create incentives for hospitals and healthcare organizations to compete in patient engagement and satisfaction. It has been in use since 2006, and its sampling protocol is designed to capture information on hospital care from the patient’s perspective.
What are the goals of the HCAHPS?
Three broad goals shape the HCAHPS survey. First, it is designed to produce comparable data on patients’ perspectives of care, allowing objective and meaningful comparisons among hospitals on topics important to consumers.
Secondly, the public reporting of the survey results is designed to create incentives for hospitals to improve the quality of care. Lastly, public reporting serves to increase transparency, thereby enhancing accountability in healthcare.
What items are on the HCAHPS survey?
In a nutshell, it asks patients about their experiences during their most recent hospital stay. Patients rate how well their hospital met their expectations in several areas. The survey is composed of 27 items – 18 substantive items that encompass the critical aspects of the hospital experience:
- Communication with doctors
- Communication with nurses
- Responsiveness of hospital staff
- Cleanliness of the hospital environment
- The quietness of the hospital environment
- Pain management
- Communication about medicines
- Discharge information
- Overall rating of hospital
- Recommendation of hospital
Aside from the abovementioned items, four items are provided to skip patients to appropriate questions. Three items are added to adjust the mix of patients across hospitals, and two items are asked to support congressionally-mandated reports.
The survey is completed by patients admitted to the hospital within the last three months and asks questions about their experience during their visit. The results are then weighted based on the severity of their illness, length of stay, and other factors, which allows CMS to compare hospitals against one another with an objective measure.
The HCAHPS survey is available in English, Spanish, Chinese, Russian, and Vietnamese in the mail format and in English and Spanish in the telephone and Interactive Voice Response formats.
On average, it takes respondents about seven minutes to complete the survey. The core questions can be combined with customized, hospital-specific items to complement the data hospitals collect to support internal customer service and quality-related activities.
When are patients surveyed?
Sampled patients are surveyed between 48 hours and six weeks after discharge, regardless of the mode of survey administration. Interviewing or distributing surveys to patients while they are still in the hospital is not permitted.
Data collection for sampled patients must end no later than six weeks following the date the first survey is mailed (Mail Only and Mixed Modes), or the first telephone attempt (Telephone Only and IVR Modes) is made.
What are ways a hospital can improve its HCAHPS score?
Increasing overall patient satisfaction correlates to how patients perceive the quality of your healthcare services. You may have a roster of the best healthcare professionals and staff. However, it does not necessarily translate into a perception of satisfaction.
The missing component is a service delivery model emphasizing the patient's participation, preferences, values, and decisions in the healthcare setting — the patient-centric approach. This model optimizes care operations to improve efficiency, efficacy, and service by empowering patients and promoting collaboration and trust with their providers.
An integrated patient-centric approach streamlines and simplifies hospital operations that offer beneficial outcomes such as cost reductions, staff satisfaction, and, most importantly, improved patient care quality.
As health care institutions are in the business of care delivery and are primarily a personnel-intensive information industry, it is best to support them with an information system that fully integrates all patient health information when optimizing operations. A streamlined hospital operation will improve coordination and save more time for staff, nurses, and physicians. Consequently, it will complement and enhance communication with patients.
Actual patient experience with your care services significantly contributes to their perceptions. Moreover, it would not matter to patients, regardless of what you say about being comfortable, for example, when they do not truly feel it.
For example, noise is among the elements that irritate patients. Comforting words or outstanding medical treatment don’t eliminate hospital noise. Create a quiet and tranquil environment wherever possible, or minimize the hospital noise you can control.
How can the ViSi Mobile Monitoring System Impact HCAHPS?
By introducing ViSi Mobile into your hospital, staff can not only impact patient safety or save the hospital money by reducing events such as pressure ulcers and unanticipated deaths. Incorporating ViSi Mobile surveillance monitoring can also help improve nursing workflow and VBP reimbursement.
ViSi Mobile can impact HCAHPS by improving the patient experience. We have patients who have shared their experience with ViSi Mobile and its liberating comfort, being able to move freely while continuously being monitored.
ViSi enables staff to respond to patient physiologic alerts, improving their perception of staff responsiveness, avoid disturbing their sleep with nighttime vital sign monitoring, improving their perception of the quietness of their hospital environment, and improve their overall perception of the quality of care they are receiving because they know staff are always keeping an eye on them, even when they are not in the room.
What must hospitals do to participate in the HCAHPS?
CMS has developed detailed Rules of Participation and Minimum Survey Requirements for hospitals that either self-administer the survey or administer the survey for multiple hospital sites and for survey vendors that conduct HCAHPS for client hospitals. The HCAHPS Rules of Participation include the following activities:
- Attend HCAHPS Introduction and Update Training
- Follow the Quality Assurance Guidelines and Policy Updates
- Attest to the accuracy of the organization’s data collection process
- Develop an HCAHPS Quality Assurance Plan
- Become a QualityNet Exchange Registered User for data submission
- Participate in oversight activities conducted by the HCAHPS Project Team.
Hospitals and survey vendors administering the survey must also meet HCAHPS Minimum Survey Requirements concerning survey experience, survey capacity, and quality control procedures. Details about these activities and requirements can be found in the Quality Assurance Guidelines under “Quality Assurance” at www.hcahpsonline.org.
