Communication key to strong HCAHPS

Since 2008 when the Centers for Medicare & Medicaid Services (CMS) first implemented the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey for U.S. hospitals, the scores from these surveys have become increasingly more important to hospital executives as a measure of quality. Indeed, they are now used to determine 30 percent of the total incentive offered to hospitals under the Hospital Value Based Purchasing program (HVBP).

Not only do HCAHPS scores provide incentive payments for hospitals, but they also provide insight into the level of patient experience being provided by the organization and areas that can be addressed to increase patient satisfaction, explained Sue Larson, president of Astute Doctor Education, Inc., a company that specializes in improving physician-patient interactions as a way to manage risk and improve outcomes. Larson added that HCAHPS data is also now publicly available on the Hospital Compare website, another competitive advantage to having stronger survey scores.

In order to successfully improve an organization's HCAHPS scores, improve the overall patient experience, and ultimately, the hospital's bottom line, hospitals and physicians will have to shift their focuses from simply improving clinical care, said Larson.

"When you consider that the majority of patients measure quality based on how well they were treated in the hospital rather than the actual treatment's success, it has never been more important for hospitals to develop a culture where quality measures such as interpersonal and communication skills, are deemed of equal importance to diagnostic, analytical and therapeutic skills," she said.

[See also: Patient education reduces readmissions and ER visits, saves money]

Bill Fera, MD, from EY's Health Care Advisory practice, explained that the most successful hospitals -- at least when it comes to having strong HCAHPS scores -- are organizations that are geared toward engaging the entire hospital community in transforming itself into a customer service-oriented, patient-centered enterprise.

"Hospitals that are able to mount successful campaigns in this regard create accountability at every level of the organization from facilities management to the quality department from transport specialists to physicians," said Fera. "Effective hospitals have been able to expand HCAHPS ownership beyond one department or one group of healthcare providers and embed it in the organization's culture."

According to Dan Virnich, chief medical officer of TeamHealth Hospital Medicine, when it comes to improving the patient experience it's really important to work on changing the mindsets of many physicians.

"Physicians can no longer just be excellent clinical providers. We have to try to promote communications with patients from an automated standpoint," he said. "Physicians should ask patients questions related to the survey in order to shut down patient concerns before they even leave the hospital."

[See also: Communication key to improving care transitions ]

Peter Semczuk, vice president and executive director of clinical services at the Moses/CHAM Campus at Montefiore Medical Center in New York, explained that improving the patient experience at Montefiore has been a primary focus at the organizations for a few years now. Semczuk explained that he is in charge of performance excellence directors for each of the 25 inpatient units at the hospital. He and the performance excellence directors meet weekly to look at their HCAHPS scores, patient comments and trends, and how they improve communications among their nurses, physicians and patients.

"We focus a lot on the communications between nurses and patients. Patients choose hospitals because of doctors, but once they are here, it's more about the patient experience with their nurses," he said. "We require our nurses to round in each patient's room every hour to assess their pain and personal needs."

Additionally, Semczuk explained that he and the other hospital executives also meet regularly with the heads of all hospital departments, including food service, housekeeping, social work, and transportation in order to discuss their roles in the overall patient experience.

Because many hospitals are unsure of the best ways to communicate to physicians, nurses and other clinicians on how they can best improve their patient communication and customer service skills, Larson explained that it's important for hospitals to spend the time and money on quality training programs.

"Hospitals should also invest in good quality training that can provide practical and comprehensive strategies that are easily available online, and can be used immediately to improve patient experience," she said. "It is also recommended to put in place personal goals and measures for all staff who will be involved in participating in an initiative. Experience has shown that strategies designed to improve the patient experience are often not operated consistently. Therefore, if an initiative is important enough to be adopted by your institution, show your staff that it's a priority by giving them accountability for its success."

[See also: Patient experience a top priority for hospital executives]