When it comes to patient satisfaction, it’s no longer enough to have a talented, hard working medical staff—healthcare providers are just one component of the patient care system. When a patient is discharged, they come away with an impression not only of the nurses and physicians that treated them, but the infrastructure that supports the staff itself.As new healthcare technologies and systems become more complex, so does managing your institution’s reputation. While consumer-level evaluation resources like Vitals.com and U.S. News & World Report provide qualitative ratings for physicians and institutions, more quantitative metrics provide constructive feedback—and in turn, more specific guidelines for improvement.
Hospital administrators across the U.S. are now targeting the complete patient experience, and one influential metric for evaluating comprehensive patient satisfaction is the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. In fact, according to a report by HealthLeaders Media, HCAHPS scores are now the most influential measurement used in evaluating patient satisfaction.
Why is a hospital’s HCAHPS score so important? First off, these results are posted publicly every year for any prospective patient (or contractor) to see. Second, the Centers for Medicare Services (CMS) reimburses hospitals based on these scores in their Annual Payment Update (APU)—so the higher the hospital’s patient satisfaction score, the more financially stable it can be.
Since 2007, hospitals have been required to submit their HCAHPS data to the government in order to receive a full APU, and today, all scores are publicly reported as well, so unsatisfactory responses can potentially affect direct government funding and revenue from would-be patients. The Centers for Medicare Services advises that surveys should be given to a random selection of eligible, discharged patients every month; and that eligible institutions attend annual HCAHPS training, adhere to its quality assurance guidelines, and develop its own HCAHPS Quality Assurance Plan. (For more information on HCAHPS hospital eligibility criteria, click here.)
One reason the HCAHPS is so influential is because of its panoramic scope—unlike the Department of Health & Human Service’s Health Center Patient Satisfaction Survey, the HCAHPS addresses the entire hospital ecosystem with an emphasis on communication, efficiency, and order. Among the dimensions included in the annual HCAHPS survey are:
Composite Topics
- Nurse Communication
- Doctor Communication
- Responsiveness of Hospital Staff
- Pain Management
- Communication About Medicines
- Discharge Information
Individual Items
- Cleanliness of Hospital Environment
- Quietness of Hospital Environment
Global Items
- Overall Rating of Hospital
- Willingness to Recommend Hospital
The HCAHPS is an indispensable resource for hospital decision makers in 2013 because its broad scope offers the C-suite tangible, targeted areas for improvement—and among the survey’s most easily improved dimensions is its “Communication about Medicines” dimension.
Out of the ten categories of the HCAHPS survey, the Communications About Medicines category received the second lowest aggregate score. U.S. hospitals that consistently report patient dissatisfaction in this area typically revolve around the inability of the patient’s care team to efficiently deliver information about medications and clearly communicate instructions about medication use—both common causes of medication tracking errors and missing doses. If pharmacists are frequently negotiating inefficient phone workflows, slow inventory updates, and fragmented compliance and security protocols, they’re spending less time giving medication information to patients and medical staff and improving the turnaround time of medication deliveries.
In Bismark, North Dakota, Sanford Medical Center’s department of pharmacy recently implemented a pharmacy rounding program, where pharmacists had dedicated time for talking to patients about medications and teaching residents. As a result, the institution’s HCAHPS scores for Communication about Medicines increased from the 8th percentile to the 83rd percentile, and 72 percent of discharged patients reported that staff “always” were available to clearly explain the goals and side effects of their prescribed medications. Despite the clear benefit, most of today’s busy hospital pharmacies would find it difficult to free up a pharmacist to make rounds. Finding efficiencies in current workflows therefore is key to improving patient care.
In addition to the benefit of improved HCAHPS scores, revenue also increased, as the revamped pharmacy workflow allowed patients to fill more prescriptions at the hospital pharmacy instead of elsewhere, thereby resulting in an additional $95,000 in pharmacy revenue in its first 9 months—with a projected annual increase of $127,000 per year.
While the pharmacy is just one area of the hospital that can impact patient satisfaction, it’s perhaps the most ripe for cost-effective investments that create a more efficient ecosystem for your medical staff. A pharmacist rounding program is just one potential element of a streamlined communication protocol that actually works, and when combined with a medication tracking system to free your staff from the burdens of bureaucracy, they can spend more time on what really matters: patient care.
