HCAHPS Scores Continue to Climb—Is Your Hospital Keeping Up?
By Robert J. Ogden, Senior Consultant (HCAHPS & Other Surveys), HealthStream
Over the last several years I have counseled hospital leaders about the importance of continuing their efforts to improve their HCAHPS scores, even if those scores were well above the national average. It became clear soon after CMS began releasing HCAHPS results that if a hospital did not improve their scores, they were falling behind. With the release of the latest update to the Hospital Compare patient experience scores, I took a look at the CMS HCAHPS scores for the past 18 quarters of reported data to see how the scores have changed over that time. What I found were some interesting observations that I would like to share.
The number of hospitals participating in the HCAHPS program continues to grow.
Since the inception of public reporting on the Hospital Compare website, when CMS reported results of 2,517 hospitals, CMS has added 1,341 hospitals, a 53% increase. CMS added 46 hospitals in just the past four quarters. The largest quarterly increase in the number of participating hospitals took place Q1 2009 when public reporting became mandatory for hospitals to receive their market basket update.
The average improvement since the beginning of public reporting across all publicly reported themes is four points.
All themes improved by 1% in one of the last four quarters, perhaps indicating acceleration in the rate of improvement. While all top box reported scores have improved, hospitals have had more success improving some themes compared to others. For example, over time, the Responsiveness of the Hospital Staff and Overall Rating of the Hospital have each improved by five points, whereas Doctor Communication has only improved by two points, from 79% top box to 81% top box. The Pain Management theme and Willingness to Recommend question have also been slower to improve, each improving by just three points from the Q1 2008 data release to the Q2 2012 release. The Nurse Communication, Communication about Medicines, Cleanliness of the Room and Bathroom, and Discharge Information themes have all improved by four points during this same time period.
Doctor Communication, already scoring extremely well, has been the most difficult theme to improve.
This theme spent 14 quarters stuck at 80% “Always” before nudging up to 81% with the release of the Q2 2012 data. Based on my conversations with many hospital leaders, hospitals did not devote as much effort to this theme while they focused on other themes. However, beginning in early 2011, it became apparent to some hospital leaders that they needed to include physicians in their HCAHPS improvement efforts and that they needed to develop action plans to improve physician communication with patients. I believe we are now beginning to see the results of those efforts in the latest CMS data.
For an interesting perspective of physician communication from a HealthStream consultant turned patient, read Bonnie Lowery’s August 27th blog, “HCAHPS: What "Always" Looks Like as a Patient.” While many organizations struggle to improve physician communication, Vidant Medical Center in Greenville, North Carolina has shown it is possible.
So… how do your hospital’s results compare to the national data? While we are seeing HCAHPS scores improve across all themes at a faster rate than at any other time, is your hospital improving at a similar rate or is it time to recommit to improving the patient experience? What HCAHPS theme has been your biggest challenge to improve? Have you been successful improving physician communication or pain management scores? If so, what have you done to improve? If your hospital, like many others, is struggling to improve these scores, the best practices found on the HealthStream Insights Online reporting website may be helpful.
Learn More about Insights Online.
Learn More about HealthStream Patient Insights/HCAHPS.