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Higher Readmission Penalties Linked to Low HCAHPS Scores
On the other hand, hospital readmission rate scores vary from the very low end, with some hospitals receiving 0-19 points, some receiving 20 to 39 points, some 40-59, some 60-79 and some 80-100.
"What we see from the metrics that make up the various quality performance initiatives is the expectation that hospitals will extend their sphere of influence," Buhlman says.
She says there's a strong probability that the hospitals' focus on readmission rates also affects its relationship with the patient through communication, and that's why these patients give hospitals higher marks in patient experience.
"One of the things we coach hospitals on is communication, of course, directly reflected in HCAHPS around discharge planning is that it's not one conversation that occurs the day the patient is being discharged," Buhlman explains.
"You begin that conversation when the patient is admitted, and that conversation can be, 'Okay, Mrs. Jones, you're here to have your hip replaced. Typically that's a two-night stay in the hospital. So we're gunning for you to be discharged on Wednesday.' And literally, periodically throughout the stay, renewing that conversation," about who will be there to pick up the patient, about medication instructions, and other elements of care after the patient gets home.
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Comments are moderated. Please be patient.
Michael Solomon, Ph.D. (1/24/2013 at 3:57 PM)
Recognizing that patient satisfaction may be a factor in helping patients avoid returning to the hospital is a good starting point, but the emphasis on HCAHPS diverts attention from the more important goal of having patients who are actively engaged in managing their health and healthcare post-discharge. Providing a patient with a discharge summary and education materials about his or her condition and helping a patient comply with having a physician exam post-discharge are practices shown to be related with reduced readmissions. Except for the patient-provider communications item, the HCAHPS does not measure these important indicators of actively engaged patients. Programs to reduce preventable readmissions should move beyond satisfied to actively engaged patients. A reliable and valid measure of patient activation, known as the PAM-13 exists. Interventions such as web-based self-management tools have been shown to increase patient activation.
Steve Wilkins (12/13/2012 at 11:37 AM)
Correlation is not the same as causality. The conclusions drawn linking patient experience (as nebulously defined by HCAHPS) to reduced hospital readmissions sure seems like a big reach to me. Steve Wilkins, MPH Mind the Gap www.healthecommunications.wordpress.com