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HCAHPS: Going for the 5-Star Care Experience

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HCAHPS: Going for the 5-Star Care Experience

HCAHPS: Going for the 5-Star Care Experience

Johns Hopkins Medicine wants every patient to have a five-star care experience.

HCAHPS Survey-JHH | Lisa Allen, Ph.D.

Lisa Allen, chief patient experience officer for Johns Hopkins Medicine, explains how we measure the patient hospital experience, particularly at The Johns Hopkins Hospital.

Date: 11/02/2015

Even when treatment is proceeding successfully, a hospital stay can be distressing. Surrounded by unfamiliar smells, sights and sounds, and perhaps in pain, the patient is acutely sensitive to every interaction with care providers. For that reason, says Zishan Siddiqui, a Johns Hopkins Hospital hospitalist who conducts research on the patient experience, physicians and other providers need to deliver care that is personal and compassionate as well as safe and high-quality.

Such characteristics define the five-star care experience that Johns Hopkins Medicine leaders aim to provide every time to every patient, with the goal of achieving a five-star rating on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey.

The HCAHPS survey is a national, standardized survey mailed to randomly selected people who recently had a hospital stay. To capture their perception of the care they received, the survey asks 32 questions, such as “How often did the doctors listen carefully to you?” The patient responds with “never,” “sometimes,” “usually” or “always.” Based on patients’ responses, the Centers for Medicare and Medicaid Services (CMS), which manages the survey, assigns hospitals a rating of one to five stars in nine aspects of care—nurse communication, physician communication, responsiveness of hospital staff, pain management, communication about medicines, discharge information, care transition, cleanliness of hospital environment and quietness of hospital environment. Additional star ratings are assigned that reflect a patient’s willingness to recommend the hospital and the patient’s assessment of the hospital’s delivery of care.

Based on these category ratings, CMS assigns an overall star rating to the hospital. Quarterly reports are published on the Hospital Compare website to help consumers make decisions about inpatient care.

In the latest report, released in October, The Johns Hopkins Hospital’s ranking is three stars, down from four stars in the previous report. The majority of the hospital’s mean domain scores did not change, says Siddiqui. But hospitals are “graded on a curve,” so as other organizations across the country improve, mean scores that used to translate into four stars now translate into three stars. 

The other Johns Hopkins Health System hospitals are ranked three and two stars.

Siddiqui’s research finds that the key to increasing patient satisfaction is focusing on communication and related interpersonal skills. He is working with The Johns Hopkins Hospital’s service excellence team, which focuses on service improvement initiatives, to educate physicians and other staff members on improving the patient experience.

Siddiqui offers these tips to physicians:

  • Introduce yourself. Sit down to talk to your patients rather than stand.
  • Do not let pages or messages distract you.
  • Ask patients about their main worries and concerns, and listen attentively with minimal interruption. Understand patients’ fears and respond to their need for information.
  • Involve patients and their families in care decisions.

Learn more about the HCAHPS survey.