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Full Disclosure
As results of a federal survey to measure the patient experience go public, Hopkins will build on its successes while addressing ways to improve care

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Becky Zuccarelli: Always checking the pulse of patient satisfaction.

In yet another push toward accountability, the government has asked hospitals across the nation to share results of a new patient satisfaction survey online. Called the Hospital Consumer Assessment of Healthcare Providers and Systems, or HCAHPS, this survey will eventually be tied to reimbursement by Medicare and to U.S. News & World Report rankings.

Hopkins’ three hospitals decided to volunteer their data, which was first posted late last month on the government’s Hospital Compare Web site. “We had an option to suppress any of our hospital scores,” says Becky Zuccarelli, senior director of service excellence for the Health System. “We chose not to because we believe in continuous improvement, and we’re working on improving all of our results. We want to learn from this.”

In general, scores for The Johns Hopkins Hospital were at or above the national average in the 10 categories that appear online, such as responsiveness of staff and communication with doctors. Johns Hopkins Bayview and Howard County General Hospital’s scores hovered around average or slightly lower.

The new report cards have gotten hospital leaders’ attention across the country, and strategies are being put into place to address the data. All Hopkins’ hospitals have added service excellence training to orientation for new employees and have become more transparent about sharing in-house survey results widely. Howard County General Hospital has added hourly rounds by nurses to address issues like pain management and toileting. At Hopkins Bayview, employees get monthly feedback about service behaviors. Hopkins Hospital finds that implementing its patient- and family-centered care model on units such as surgery and obstetrics consistently improves satisfaction scores.

Still, says JHH Chief Operating Officer Judy Reitz, “we need to be highly focused on exceeding patients’ expectations to keep our reputation strong. For more than a decade, we’ve been assessing patient satisfaction. Now that consumer education is growing—and that’s a good thing—we need to intensify our efforts and truly achieve ‘service equal to our science.’”

At the Hopkins Hospital, she notes, the weakest link right now is food service, which is in the midst of several pilot programs to mimic restaurant-style ordering and presentation, efforts she hopes will meet patients’ expectations.

Zuccarelli emphasizes that reaching nurses is key, because “for inpatients, it’s nursing care that drives the overall results.” Although issues like cleanliness and quietness aren’t limited to nursing, “if we could get the entire staff engaged in that, that would be great.”

The survey is sponsored by the Centers for Medicare and Medicaid Services (CMS) and the Agency for Healthcare Research and Quality, the nation's lead federal agency for research on health care quality, costs, outcomes and patient safety. The data is the latest addition to the government Web site, which also offers comparative information to consumers on conditions such as heart failure and pneumonia.

The HCAHPS survey, which consists of 27 questions and gets mailed to 50 percent of adult inpatients, is attached to Hopkins’ own Press Ganey satisfaction questionnaire. The first data period covers the nine months between October 2006 and June 2007.

—Staff Report

HCAHPS and other survey results can be found at



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