Understanding In-Center Hemodialysis CAHPS (ICH-CAHPS)
By John Merrit, Regional Director, HealthStream
ICH-CAHPS is Now a Required Survey for In-Center Dialysis Treatment Centers
In-Center Hemodialysis Consumer Assessment of Healthcare Providers and Systems (ICH-CAHPS) probably sounds complicated and maybe even intimidating. However, these are simply the new terms used to evaluate patients' experiences at a dialysis or kidney center. The ICH-CAHPS survey has elicited numerous questions, which we will attempt to answer in this article.
In-Center Hemodialysis CAHPS Sets a Uniform Standard for Assessing the Hemodialysis Patient Experience
While in-center hemodialysis clinics have been reporting comparative clinical information at the facility level since January 2001, there has been no uniform method for evaluating the patient experience. During the middle of the last decade the agency for healthcare research and quality (AHRQ) conducted an 18 month pilot survey with seven facilities and four networks. In November 2007 the ICH-CAHPS survey was approved by the national quality forum (NQF). AHRQ explains the reason why they decided to capture information on patients' experiences rather than satisfaction is because "reports about events and behaviors are more specific, actionable, understandable, and objective than general ratings." In order to evaluate these patients' experiences, the CAHPS-style of questions typically evaluate behaviors and utilize the frequency-based scale of Never, Sometimes, Usually, and Always (19 questions). There are two other scales used within the survey; these are 0-10 Overall Rating (3 questions), Yes-No (15 questions).
In-Center Hemodialysis Survey Details
The ICH-CAHPS survey is intended for adults only, and only those with at least three months of experience on hemodialysis at their current facility are eligible. The survey contains 58 total questions, and it can be customized with additional questions. Of the 58 questions, 14 are demographic, 7 are screener questions, and 37 evaluate the patients’ experience. Only 21 questions are actually considered key CAHPS items, and just 12 of these key CAHPS items need to be answered in order for a survey to be deemed complete.
Each clinic must attempt to contact either 200 patients or conduct a full census if there are less than 200 patients. It has been determined that the ICH-CAHPS survey must be administered by a third-party, and telephone is the best methodology for dialysis patients. AHRQ states "because many patients with end-stage renal disease have problems with vision, low literacy, and fatigue, a mail-only protocol is not recommended for this survey." An introduction letter explaining the purpose of the survey must be sent to each eligible patient before attempting to contact them via telephone. To ensure the best possible response, 10 attempts must be made to contact each patient, and these attempts must be made at different times of the day and on different days of the week. Spanish is an approved language for the ICH-CAHPS, and telephone surveys should not be completed by anyone other than the patient.
HealthStream is a leading provider of Patient Experience surveys, and the CAHPS-aligned approach has proven immensely successful in helping organizations improve. HealthStream is the leading provider of telephone administered CAHPS surveys nationwide.
Learn More About ICH-CAHPS.