In 2007, the Centers for Medicare and Medicaid Services began requiring many hospitals in the United States to randomly survey patients who had stayed at least one night in the hospital. The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey provides hospitals with valuable performance measurement data built around patient experience, while providing consumers with a valid comparison tool.
This research analyzed six years of unadjusted HCAHPS survey data from five hospitals within the same organizational system. Qualitative data gathered through informal interviews and observations from the Medical-Surgical unit at four of the five hospitals allowed for an in-depth investigation of the factors behind the quantitative analysis.
Analysis of the quantitative data found statistically significant differences in six of the nine HCAHPS variables analyzed. Qualitative data provided insight into some of the factors likely influencing the differences. Hospital size, physical layout, hospital utilization, and lack of standardization of processes around patient care were identified as factors influencing differences.
Interviews and observations found that though the organization was passively sharing some of the HCAHPS data with employees, employees had little knowledge of HCAHPS. Though some employees expressed negative views of HCAHPS, there appeared to be little correlation between employee opinion about HCAHPS and HCAHPS results.
HCAHPS provides hospital organizations with an opportunity to enhance their own performance measurement systems by incorporating the HCAHPS patient data. These data provide hospitals with feedback that can be utilized to focus improvement efforts where investment of resources will provide the most benefit. This research found that some HCAHPS variables would be difficult to improve without costly capital improvements. For many of the HCAHPS variables, however, the hospital could use the data to drive performance improvement efforts around patient care processes already in place.