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Patient Experience Scores Skew by Region, Providers Say

Cheryl Clark, for HealthLeaders Media, January 18, 2011

But the percentages who answered positively to this question declined as the number of beds per hospital went up.  For hospitals with 51-149 beds, positive response to communication with nurses was only 76% and for hospitals with 600 or more beds, 73%.

Dennis Kaltenberg, chief science officer for Press Ganey, says it's unclear why survey responses vary so much by region and bed size. "It's difficult to say whether it's the way patients answer questions, or it's the actual (quality of) the services being delivered," he says.

Childs says that assigning a weight of 30% to payment based on patient experience scores is controversial, and Premier is still studying the issue before issuing its written comments to CMS.

"I expect this will be a hotly-debated topic," Childs says.

Under the proposed regulations, hospitals will start receiving adjusted payments based on scores received on the following:

• 17 process of care measures. These include whether a patient with an acute myocardial infarction received an aspirin at discharge, or whether patients received prophylactic antibiotics prior to surgery.

• 8 patient experience of care measures asked within the HCAHPS survey, such as how well they perceived communication with their nurses and doctors, the responsiveness of hospital staff and their perception of the adequacy of pain management. HCAHPS surveys are administered randomly to patients between 48 hours and six weeks after discharge, and is not restricted to Medicare beneficiaries.

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8 comments on "Patient Experience Scores Skew by Region, Providers Say"


R Daniel King (1/20/2011 at 7:47 AM)
Presently, hospital organizational culture thrives in two environments: political or accountable. The majority function in a political environment where leadership chooses the politically protected and politically isolated creating a win/lose polarizing environment that fosters dependency and mistrust that leads to failure in patient and financial outcomes. In an environment of accountability everyone is accountable, starting with leadership, creating a win/win innovative environment that fosters interdependency and trust that leads to excellence in patient and financial outcomes. Simply stated, it's the culture stupid, and the dominance of the win/lose political environment where hospital departments function as bunkers where the politically protected fight and scheme to preserve the status quo and the politically isolated struggle and mostly fail to inject excellence. This environment is why hospitals have almost as many annual preventable deaths as all of World War II. That fact alone sums up the patient experience and the only way to lower it is the hospital industry realize it has a leadership chasm that has led to a quality chasm that is unaffordable thanks to the decades of command and control self-serving regulations inflicted by CMS. Until the federal government and hospital leadership accept this fact, because cultural change starts with leadership, the nation's health care delivery system will remain operationally inefficient and quality challenged on a path to economic Armageddon. And nothing in the present design of ObamaCare will deter this ending, if anything it will accelerate it.

Michael Krivich, FACHE, PCM (1/19/2011 at 1:43 PM)
As difficult as this appears to be, providers need to begin looking outside of themselves and using Customer Experience Management to solve this challenege. Individuals are only "patients" 1/3rd of the time you interact with them. The other 2/3rds of the time they are customers. CEM requires the organization to manage the individuals experience across all touch-points beginning to end. Only then when you are actively managing customer experiences and meeting expectations, will you be able to improve satisfaction, revenue and market share. It is not impossible if you apply innovation, creativity and learnings from other industries.

Micahel Krivich (1/19/2011 at 1:29 PM)
It's time for the healthcare industry, namely hospitals and health system to manage customer experiences though customer experience management programs. More than just the "patient" experience, it forces the organzation to understand and manage those experiences enhancing that experience. CEM leads to higher quality, lower cost, increased revenue and market share. It forces an organzation to look outside-in instead of inside-out based on the view of their customers. Individuals aree only patienst in only 1/3rd of the time you interact with them. The other 2/3rds of the time they are consumers. So maybe its time to start lisening to them and using that to drive change.