Aurora, Colo. (PRWEB) August 02, 2012
The impact of nursing care on patient satisfaction and patient outcomes has long been established but hadn’t been linked to financial incentives – until now, with the Hospital Consumer Assessment of Healthcare Providers and Systems initiative. (Abbreviated as HCAHPS and often pronounced as “H-caps.”) According to one nursing educator, HCAHPS is poised to have a profound impact on health care and offers a positive and unexpected opportunity to advance the entire nursing profession.
“The power of HCAHPS is that it has forced institutions to take the patient’s perspective into serious consideration,” says Elaine Townsley, DHA, MSN, MBA, faculty, health sciences and nursing at American Sentinel University. “We now have a science focused around patient-centered care and a way to measure care that was not in place before. When a nurse is aware of the patient’s perception of the care they are receiving, the nurse can now take measures to correct any negative habits and use the information as a learning tool to increase quality of patient care.”
How HCAHPS Works
HCAHPS is part of Medicare’s new value-based purchasing program, which is an effort to shift to reimbursement models that pay for high-quality care rather than a high quantity of care. HCAHPS itself is a survey instrument that aims to measure patient satisfaction with the entire hospital experience.
Recently discharged patients are asked to answer 27 questions that are used to measure how they feel about the care they received in the hospital. It includes seven key topic areas: responsiveness of hospital staff, nursing communication skills, physician communication skills, pain management, quietness and cleanliness, explanations about medications and discharge instructions. View the actual survey questions online here.
The survey is designed to allow objective and meaningful comparisons between hospitals in areas that are important to consumers. Results are published online and can be viewed by the public at http://www.hospitalcompare.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.
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