Description of the HCAHPS Survey
Provision of high quality care in health centers is vital owing to consequent patient-satisfaction that positively influences the center’s HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) scores. The HCAHPS Survey is a quantitative and assessment tool used for overall evaluation of the qualitative link between staff and patients in a health center (Nickitas, Aries, & Middaugh, 2014, p. 153). The survey widely targets patients aged 18 years and above during their admission to a health center, and additionally includes patients who have spent at least one night as inpatients within the center. Generally, the survey addresses nine major topics that include communication and relationship with nurses, relationship with doctors, pain management, responsiveness and care of the center’s staff, discharge information, communication regarding medicines, and care transition (Gatchel, Howard, & Kishino, 2008, par. 3). Other topics include quietness and tranquility of hospital’s ambiance and cleanliness of hospital’s environment.
The HCAHPS survey additionally incorporates seven demographic questions and four screener items that purport to adjust and analyze the mix and interaction of patients across health centers (HealthcareSource, 2012, p. 1). The survey therefore includes thirty-two questions, of which three address the topic of pain management that allows nurses to incorporate compassion and medicines such as topical anesthesia to facilitate for positive experiences for patients. Higher satisfaction of patients would equally lead to an improvement in HCAHPS results, which remains the prime objective of each health care center in order to avoid losing reimbursement of medical care, penalization for unsatisfying HCAHPS scores, and to promote the maintenance of market share (HealthcareSource, 2012, p. 3).
Several among the questions in the survey require a ‘never’, ‘sometimes’, ‘usually’, or always response. Facilities receive high rates of reimbursement from the CMS (Centers for Medicare and Medicaid Services) in the event that they have a high number of satisfied inpatients (Healthcare Review, 2010, par. 5). Consequently, several care organizations strive to establish an ‘always culture,’ where each staff member would feel accountable for patients’ satisfaction. Learning about the best care center and best experiences within given hospitals is easy for patients, since stakeholders post the HCAHPS results and scores on a public site. The site allows patients to make comparisons between health centers basing on their perspectives on effective care. Consequently, educated and learned patients may choose on patronizing health centers that have high HCAHPS scores.
HCAHPS Development, Endorsement, and Testing
In 2002, the Centers for Medicare and Medicaid Services established a partnership with AHRQ (Agency for Healthcare Research and Quality) for the development and testing of HCAHPS survey (Nickitas, Aries, & Middaugh, 2014, p. 155). Consequently, AHRQ executed rigorous scientific processes that included a call for literature preview, measures, stakeholder input, focus groups, cognitive interviews, and consumer testing. In the event of the processes, CMS provided a minimum of three opportunities to various individuals to make comments on the HCAHPS survey, and equally provided responses to approximately one thousand ideas.
Consequently, the National Quality Forum endorsed the HCAHPS survey in early 2005. In addition, in late 2005, the Office of Management and Budget provided a final approval for HCAHPS implementation, which would allow public for public reporting (Nickitas, Aries, & Middaugh, 2014, p. 156). Hospitals therefore use the HCAHPS survey within Hospital Quality Alliance auspices, which is a public/private partnership that incorporates main medical associations and accrediting bodies, measurement, and consumer groups. The HQA thus endorsed the HCAHPS survey (Gatchel, Howard, & Kishino, 2008, par. 5).
The Deficit Reduction Act’s enactment in 2005 provided additional incentives for acute health centers to engage in the survey. Since early 2007, healthcare centers follow the Inpatient Prospective Payment System that provides for collection and submission of the HCAHPS data and report in order for them to receive the entire IPPS annual update of payment. IPPS healthcare centers that publicly fail to report and present quality measures may suffer a 2 percent point-reduction on the annual update of payment (TraumaRus, MSN, APRN, CNS, 2013, par. 12). Consequently, the endorsement and implementation of the HCAHPS survey has a profound effect on nursing/healthcare.
Effects of the HACAHPS Survey on Healthcare/nursing
The use and implementation of HCAHPS survey in healthcare centers positively impacts on pain management, since the management of pain contribute vastly in patients’ satisfaction. Most patients would prefer a certain healthcare center to the other basing on their recurrent strategies of pain management by observing the HCAHPS scores and ratings (Centers for Medicare & Medicaid Services (CMS), 2014, par. 3). The survey therefore influences and promotes quality administration of pain-reduction incentives, since various questions address on the topic of pain management. The ‘pain management’ questions seek to find out the number of times the healthcare staffs administered pain incentives to patients the efforts the staff exerted in order to help patients in pain. In order to gain quality scores, healthcare givers and nurses would therefore strive to ensure continuous administration of pain-regulation incentives (TraumaRus, MSN, APRN, CNS, 2013, par. 2).
The HCAHPS holds nurses accountable for patients’ satisfaction, hence facilitates for efficient communication within the nurses. Efficient communication within nurses and holding them accountable for patient satisfaction would equally amount to patient satisfaction, since nurses would be in a position to receive feedback on their performances and facilitate for improvement. Furthermore, the fact that the survey attributes for accountability in turn initiates a caring sensation within the nurses, since it allows for checks and balances (Centers for Medicare & Medicaid Services (CMS), 2014, par. 9).
The HCAHPS survey offers a positive impact on nursing and healthcare giving, since it provides a patient-centered approach in the administration of care (Healthcare Review, 2010, par. 8). The questions in the survey seek to promote patient satisfaction, owing to the fact that they base on administration of care to the patients and addresses topics such as pain management, care transition, and administration of medicine. Ensuring the utilization of patient-center approach in health administration is paramount, since nurses would be in a position to assess their services and create rooms for improvement with regard to patients’ perception and response on the services.
Additionally, the survey provides a suitable ambiance for nurse-patient interaction, which equally facilitates for efficient communication between them. Questions that seek responses on how nurses explained terms to patients and how they treated and cared for the patients, promote quality interaction. Consequently, nurses would be in a better position to assess the quality of their services through patients’ comments and opinions, which would improve their performances (Nickitas, Aries, & Middaugh, 2014, p. 157).
The HCAHPS survey additionally provides patients with the opportunity to choose the best services from several options (HealthcareSource, 2012, p. 3). Patients are eligible to assess and choose the best healthcare services from the survey’s site, which provides overall HCAHPS ratings and scores. Hospitals’ high-rate maintenance, which incorporates effective and diversification in administration of healthcare to patients, attracts a wide number of patients and other stakeholders.
Despite HCAHPS survey’s success in the establishment of good patient-nurse relationship, the tool has a number of limitations on healthcare and nursing. The HCAHPS survey incorporates questions that may lead to the complete downfall of a hospital in future (HealthcareSource, 2012, p. 2). Questions that seek response on the probability of a patient to visit a particular hospital again or recommend the center to his or her friends in future may trigger a hospital’s downfall in future, in the event of a negative response. The question largely seeks to determine a hospital’s score rather than the patient’s satisfaction within the hospital, owing to the fact that various individuals generally prefer given hospitals to others (Nickitas, Aries, & Middaugh, 2014, p. 154). In addition, the mantra doctors use in order to maintain satisfaction within their patients includes never denying them whatever request for pain medicines, scans, antibiotics, and hospital admission (Healthcare Review, 2010, par. 9). ` Consequently, hospitals strive to maintain high scores in the HCAHPS survey and prevent the slashing of Medicare reimbursements by over-prescribing and over-treating, which equally translates into vast costs on the healthcare system. In addition, over-prescribing and over-treating unveils the low probability of patients’ satisfaction and the high risk of their health (TraumaRus, MSN, APRN, CNS, 2013, par 5).
A patient’s assessment of quality and effective care does not necessarily correspond to clinical quality measures. Consequently, a healthcare center with high HCAHPS survey scores might not provide quality healthcare services. Various factors within the assessment tool unfairly penalize healthcare centers that are extremely busy owing to high caseloads. On the contrary, healthcare centers with large number of caseloads would always have the best medical outcomes.
Additionally, in order to promote patient satisfaction, various healthcare centers resorted to provide amenities and hotel-like accommodation for patients. A provision of extra amenities adds unnecessary costs on a country’s healthcare bill (Centers for Medicare & Medicaid Services (CMS), 2014, par. 10).
In conclusion, the HCAHPS survey is a tool for assessing a hospital’s quality of care administration to patients. Scores and ratings from various patients therefore determine the quality of care in a given healthcare center. Consequently, the HCAHPS survey attracts a series of impacts to healthcare and nursing. The positive and negative impacts therefore provide an insight to the effectiveness of the survey.
Centers for Medicare & Medicaid Services (CMS. (2014, September 3). HCAHPS: Patients’ Perspectives of Care Survey. Retrieved from Centers for Medicare & Medicaid Services (CMS).: http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-instruments/HospitalQualityInits/Hospital-
Gatchel, R. J., Howard, K. J., & Kishino, N. D. (2008, May 1). The Biophysical Approach. Retrieved from Practical Pain Management: http://www.practicalpainmanagement.com/treatments/psychological/biopsychosocial-approach
Healthcare Review. (2010, June 4). The Age of HCAHPS: Four Reasons Why Those 27 Questions Will Change Healthcare Forever. Retrieved from Healthcare Review: http://www.healthcarereview.com/2010/06/the-age-of-hcahps-four-reasons-why-those-27-survey-questions-will-change-healthcare-forever/
HealthcareSource. (2012, December March). Improve Performance with Employee Accountability Initiatives: Long-Term Care White Paper. Retrieved from HealthcareSource: www.healthcaresource.com/img/documents/hcs182-ltc-accountability-whitepaper-0312.pdf
Nickitas, D. M., Aries, N., & Middaugh, D. J. (2014). Policy and Politics for Nurses and Other Health Professionals. Burlington: Jones & Bartlett Publishers.
TraumaRus, MSN, APRN, CNS. (2013, November 17). Pain Management Nursing. Retrieved from allunurses: http://allnurses.com/pain-management-nursing/pain-management-nursing-888709.html