lcompare.hhs.gov.
The data will be used to determine reimbursement – and hospitals can gain or lose up to two percent of their Medicare reimbursement fees, depending on how well they score. (A hospital that chooses not to participate in HCAHPS is automatically docked two percent.)
“All effective communications between health care providers increases the continuity of care between providers which should equate to better patient outcomes,” says Dr. Townsley. “Organizations need to promote total customer satisfaction to their patient, their vendor, but even more so – their staff.”
HCAHPS survey data is already being collected and tallied and the Centers for Medicare and Medicaid Services (CMS) will begin implementing value-based incentive payments for hospitals in 2013.
HCAHPS Benefits Nurses
Nurses are the backbone of any health care institution and are the ‘face’ of the daily care that patients receive. So it’s no surprise that the HCAHPS survey section on nurses’ communication has been found to have the greatest impact on overall patient satisfaction and likelihood to recommend the hospital to family and friends. But some nurses are uneasy about being held accountable for overall patient satisfaction, based on comments posted on online nursing discussion forums.
The most oft-cited concern relates to the way patient responses are weighted for reimbursement purposes. The survey asks questions like how often nurses communicate well or respond quickly to a patient request. Patients can respond with ‘Always,’ ‘Usually,’ ‘Sometimes,’ or ‘Never’ – but hospitals only receive credit for the ‘Always’ responses.
Health care providers know that this all-or-nothing approach can be troublesome. Even when they’re providing very high quality care, there’s sometimes a situation that keeps them from answering a patient’s call light as quickly as they may have liked to.
Still, Dr. Townsley says that nurses can view the HCAHPS initiative as a positive and unexpected opportunity to advance nursing interests.
For example, studies have shown that patient satisfaction is higher when nurses have a better work environment, greater collaboration with physicians and more favorable staffing ratios. Hospitals haven’t always taken note of this data, but now they may have to – and nurses are poised to benefit when they do.
In addition, HCAHPS is the opportunity for which nurses have waited to demonstrate that what they do does make a difference in health care.
“I think HCAHPS is just a step, but nurses need to be on the frontline of opening communications with the upper level of management in their health care organization,” says Dr. Townsley.
Dr. Townsley points out that health care organizations will worry about their bottom line and they are going to shift their thoughts to increasing quality of care while receiving a different reimbursement for a while. If health care organizations can see that nurses are there to work with them and increase the overall quality of care, payment for services will also increase.
“Quality of care, patient care, patient satisfaction and reimbursement should be viewed together and not as separate entities,” says Dr. Townsley.
It looks like the stars are finally aligning for nursing to be seen as a revenue-producing department as nurses will be measured by their contribution to the solvency of the nation’s hospitals. Nurses now have the opportunity to demonstrate that what they do indeed makes a difference.
How Nurses Can Make Difference
Every patient interaction with which a nurse is involved now has the ability to affect hospital revenue. View the actual HCAHPS questionnaire here and become familiar with the topics patients will be asked about.
It’s the patients’ perception of care that will matter and nurses can sometimes influence that perception in positive ways through their dialogue.
“It’s critical that nurses practice communication, continuity and compassion,” says Dr. Townsley. She offers the following tips for improving patient satisfaction.
-Listen to the patient – don’t just hear them. Listening takes many av