California Hospital Volunteer Leadership Conference HCAHPS and Volunteers Deborah Austin, Director, Patient Relations/Accreditation John Muir Health February 19, 2014
CAPHS..What is it? It s a Survey Collect information Assess Public Opinion Adjustments based on findings 2
What was your first survey? Will you be my girlfriend? Yes No 3
Will you be my girlfriend? Yes X No, and I will tell the teacher on you if you keep bothering me 4
CAPHS..What is it? Consumer Assessment of Healthcare Providers and Systems Produces comparable data for public reporting Creates incentive for organizations to improve Enhances public accountability and transparency Survey Types HCAHPS Hospital CAHPS HHCAPHS Home Health Care CAHPS CGCAPHS Clinician & Group CAPHS (Physician Offices) CAHPS provides an apples to apples metric for public reporting 5
Why is CAPHS important? Consumers have access to the data Some use CAHPS data to choose hospitals CAHPS is in the public eye Participation linked to reimbursement Increases hospital accountable for quality improvement Enhances public accountability Reduces mortality rates Reduces readmission rates Affects reimbursement It s the right thing to do 6
Current Survey Questions The HCAHPS survey consists of 32 questions: 19 evaluative questions about patient care: 17 never/sometimes/usually/always. 2 yes/no. 2 global ratings: 0-10 scale. 4 point scale: Definitely No to Definitely Yes. 4 screening questions. 7 demographic questions (About You). 7
HCAHPS Survey Format Evaluative Questions About You Questions Global Rating Questions Screening Questions 8
Survey Population Who is included? Patients 18 years or older at time of admission Include patients of all payer types (not just Medicare) Admission includes at least one overnight stay in the hospital Non-psychiatric patients (defined by MSDRG) as principle diagnosis at discharge Alive at time of discharge Who is excluded? No-Publicity patients Court/Law enforcement patients (i.e., prisoners) Patients with a foreign home address Patients discharged to hospice care Patients who are excluded due to state regulations 9
So what s publically reported? Communication with Doctors Communication with Nurses Responsiveness of Hospital Staff Pain Control Communication about Medicines Discharge Information Cleanliness of Physical Environment Quiet of Physical Environment Overall Rating of Care Likelihood to Recommend 10
What does the Public See? TOP BOX Ratings H-CAHPS Scales Always Usually Sometimes Never Definitely Yes Probably Yes Probably No Definitely No Yes No 10 9 8 7 6 5 4 3 2 1 0 11
Where can the public see the data? www.hospitalcompare.com 12
Patients who reported that their nurses Always communicated well Patients who reported that their nurses Usually communicated well Patients who reported that their nurses Sometimes or Never communicated well Data Collected From Data Collected to California Average National Average California Average National Average 13 74% 20% 6% 4/1/2012 3/31/2013 78% 17% 5% 4/1/2012 3/31/2013 Patients who reported that their doctors Always communicated well Patients who reported that their doctors Usually communicated well Patients who reported that their doctors Sometimes or Never communicated well Data Collected From Data Collected to 78% 16% 6% 4/1/2012 3/31/2013 81% 15% 4% 4/1/2012 3/31/2013
What does this mean for hospitals? 14
Value-Based Purchasing Common Terminology: Pay for performance or Pay for quality Health Reform Updates Value Based Purchasing started fiscal year 2013 Current hospital VBP program will transition from Pay-for-Reporting to Pay-for Performance Up to 2% of your Medicare reimbursement will be at stake Hospitals will lose reimbursement unless their performance is at benchmark levels Includes HCAHPS performance and Core Measures Will start at 1% and this will be ramped up to 2% by 2017 Who will be reimbursed for HCAHPS performance? Top performing healthcare providers Greatest improving healthcare providers 15
2013 2014 2015 16
HCAHPS Dimensions Eight HCAHPS dimensions included in VBP: Communication with Nurses Communication with Doctors Responsiveness of Hospital Staff Pain Management Communication about Medicines Cleanliness & Quietness of Hospital Environment Discharge Information Overall Rating of Hospital All HCAHPS dimensions weighted equally within the Patient Experience of Care (HCAHPS) domain 17
How can volunteers get involved? 18
Get Involved Discuss with the Volunteer Office the patient experience brand promise. Learn which departments have opportunities Inform the Volunteer Office and/or Administration that you want to help improve the patient s experience Once assigned to a department find out what the current focus is for that departments Align yourself with what other departments are doing Ask to be a part of Patient Experience activities (Patient Satisfaction/Experience, Human Resource, Patient & Family Advisory, etc.) 19
Learn about HCAPHS Ask for copies of the CAHPS surveys Familiarize yourself with the questions Learn about the process how a patient gets a survey and who administers it Search for comments related to the volunteers Visit www.hospitalcompare.com and research your facilities scores 20
Orientation/In-service to Volunteers Put together an In-service o Volunteers should be educated on the surveys, the HCAHPS component and what it means to your hospital. o Go over each component of the survey with them. o Make sure they know that the data collected from patients is the patient s perception of how their hospital stay was. Invest in customer service and communication training 21
Empower Volunteers Communication If volunteer becomes aware of an issue for a patient/family, that volunteer should be empowered to contact the appropriate department. For example, if patient complains that food is not adequate the volunteer should call Nutrition Services and request that they obtain the patient preferences. Service Recovery If volunteer becomes aware of a minor inconvenience they should be empowered to present a Service Recovery item (if you have a program) 22
Remember HCAHPS Hospital Consumer Assessment of Healthcare Providers and Systems OR How Can you Always Help Patients (and Providers) Succeed? 23
What Message Are We Sending Behavior vs. Intent 24
Will you be my girlfriend? Yes No 25
20 years later 26