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Hospital Inpatient Experience
- A positive patient and family experience while in the hospital often results in better overall health outcomes for the patient.
- Clear communication from health care providers helps patients and families understand how to best manage their health and lower the likelihood of readmission to a hospital.
- A standardized national survey sent in the mail to adult patients asks about their experience of care at the hospital.
What is this measure?
Johns Hopkins Medicine monitors patient experience survey results as one way to ensure patients and families have a positive experience.
A standardized national survey called Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is mailed to some patients after discharge to provide their perspective of how they experienced care from the hospital.
The survey asks adult patients questions about clear communication, discharge planning, the hospital environment and the patient’s overall experience.
Patient responses are submitted to the Centers for Medicare and Medicaid Services, which publicly reports the annual results from all U.S. hospitals online at Hospital Compare.
See examples of HCAHPS survey questions
- During this hospital stay, how often did nurses treat you with courtesy and respect?
- Before giving you any new medicine, how often did hospital staff describe possible side effects in a way you could understand?
- During your hospital stay, did hospital staff talk with you about whether you would have the help you needed when you left the hospital?
Patients have the choice of responding with always, usually, sometimes or never. The percentage of “always” responses are shown in the data graphs below.
CMS Star Ratings
To make it easier for patients to understand Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey scores, the Centers for Medicare and Medicaid Services (CMS) developed a five-star rating system in 2015. Hospitals are given between one and five stars for 11 categories, as well as an overall summary. CMS calculates the number of stars by converting patient survey responses into scores.
CMS calculates the Summary Star rating based on the average from all 11 categories of survey questions.
Communication with Nurses
Survey questions ask how often your nurses listened carefully, explained things clearly and treated you with courtesy and respect.
Communication with Doctors
Survey questions ask how often your doctors listened carefully, explained things clearly and treated you with courtesy and respect.
Responsiveness of Hospital Staff
Survey questions ask how quickly you received help after pressing the call button or when needing to use the bathroom.
Survey questions ask how often your pain was well controlled and if staff did everything they could to help ease your pain.
Communication about Medications
Survey questions ask how often hospital staff told you what medications were for and clearly explained possible side effects.
Survey questions ask if hospital staff asked if you had the help you needed when you left the hospital and if you received health information on paper.
Survey questions ask if staff took your preferences into account, if you understood how to manage your health after leaving the hospital and if you knew the purpose for each medication.
Cleanliness of Hospital Environment
Survey question asks how often your room and bathroom were kept clean.
Quietness of Hospital Environment
Survey question asks how often the area around your room was quiet at night.
Overall Rating of Hospital
Survey question asks you to give the hospital a score from 0 to 10, with 10 being the best possible.
Willingness to Recommend Hospital
Survey question asks if you would recommend the hospital to family and friends.
Why is it important?
HCAHPS survey questions are designed to measure how often key components of a hospital admission happen. Patients and families can use HCAHPS survey results to objectively compare hospitals locally or nationally on inpatient perspectives on delivery of care.
Many of the questions ask if the patient received clear communication from health care providers. This information is critical for patients and families so they can understand how to best manage their health. For example, if a patient is clear about discharge instructions, it leads to overall better health and a lower likelihood of a hospital readmission.
What is Johns Hopkins Medicine doing to continue to improve?
Patient- and family-centered care is a key focus for Johns Hopkins Medicine. Each hospital has teams devoted to the highest level of service excellence and patient satisfaction.
The Johns Hopkins Hospital implemented 24/7 visiting hours on all units. This was done to kep families near their loved ones during a hospital stay. New areas of the hospital include private rooms and sleep furniture for one family member to stay in the patient room at night.
Patients and families coming to the emergency room at Johns Hopkins hospitals are promptly greeted by a staff member to help direct them where to go and to reduce the patient’s anxiety.
Listening to Patients
All Johns Hopkins Medicine hospitals seek regular feedback directly from past patients and families through Patient and Family Advisory Councils. The Councils bring former patients and family members together with hospital leaders and staff to address patient experience needs and develop new ideas for improving patient care and communication.
Executive leaders also make rounds on patient floors to informally ask patients and families about their experiences. This helps give leadership a view of what is going well and what areas need improvement.
Brigid Linsenmeyer, RN, PCCN
Registered Nurse, Howard County General Hospital
“Working in an intensive care unit (ICU), the best parts of my job are getting to know my patients and their loved ones and making them feel safe and comfortable. Any gesture of compassion that we can offer to show that we care means a tremendous amount to our patients and their loved ones.
To improve the patient’s experience, we encourage families to get involved in our daily multidisciplinary rounds. This collaboration helps ensure that all members of the care team and any family members present understand the patient’s goals for the day. We have also developed guidelines so that the nurses change shifts at the patient’s bedside instead of at the nurses’ station.
We make great efforts to foster open communication between the care team and the patients and their loved ones. One of our patients recently had a long stay in the ICU. His spouse was extremely supportive and involved with his plan of care. She greatly appreciated being able to participate in rounds each day and valued being “part of the team.” She received answers to her questions, advocated for her husband, and began planning for the care and therapy he would need in the weeks following his ICU stay. Her involvement empowered her to get to know the care team and to hear directly from them about the rationale for decisions regarding her husband’s care.
In my work, it is important to me that I provide a high level of care and compassion to my patients and their families each day. Knowing that someone cares and is listening does make a difference!”
How can patients and families support safety?
Knowing about your health condition, medications and plan for future care are critical for keeping you healthy. If you are unclear about anything regarding your health condition or treatment, ask your health care team for help. You also can contact a patient advocate if you feel any concerns are not being addressed.
If you are interested in joining a Patient and Family Advisory Council, please contact firstname.lastname@example.org.
Communicating with Your Health Care Team
Hospital stays and medical treatments can be stressful for patients and families. Communication can be challenging, and it may be difficult to know what questions to ask your health care team. Many resources are available to empower patients to effectively communicate questions and concerns with their doctors, leading to better, safer health care.
One resource is Doctella, developed in consultation with patient safety physician experts at Johns Hopkins Medicine. The online tool provides patients with specialized checklists of questions to ask their health care team and to-do lists to get organized before a medical procedure, surgery or exam.
Examples of questions from checklists:
- How soon do you recommend I have this surgery?
- Will I need anesthesia for this procedure?
- What are my options for pain medications after surgery?
Patients who want to learn more can visit the Doctella web site to access checklists for surgeries and procedures. Click here.