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HCAHPS Scores Show Wide Variation

Cheryl Clark, for HealthLeaders Media, May 30, 2012

At 10-year-old Oklahoma Heart Hospital, director Cindy Miller says, "the whole architecture is designed so that patients feel they're the only patient in the hospital; it's quiet."  But key to their high-end patient experience scores is their low nurse-to-patient ratio, which Miller says "is unmatched. If a patient needs three nurses, that's what the patient gets."

Second on the OHH's list is an aggressive service recovery effort. "We openly admit our boo-boos and try to amend with the patient proactively," Miller says. For example, if there's a scheduling mixup, a patient might receive a free hotel stay, flowers, free meals "whatever we can do."

Now eight years old, Lafayette uses concierges to escort patients where they need to be at all times, and "takes every complaint seriously," says Richard LeBlanc, Heart Hospital of Lafayette's director of performance improvement and risk management. "I don't care if they say they don't like the TV remote, we get them a new one. Or if anything is wrong with the food, the dietician comes to fix it." Family members can stay with their loved ones through their ICU recovery.

Some officials for some hospitals on the lower end of the HCAHPS scorecard blame their poor responses on the fact that they serve a low-income population or are located in a lower socioeconomic region.

Patricia Simon, Jackson Park's vice president for quality and compliance, says that Jackson Park treats a population in a highly underserved area where a lot of patients are funded through public aid programs.

Cathy Kutzler, CEO of St. Joseph's, says her hospital has a disadvantage on the HCAHPS survey because 98% of the patients that come there are brought in by fire and rescue services and don't see St. Joseph's as their hospital. Additionally, she says, while the emergency department  was rebuilt in the last three years, the rest of the hospital is old. "We receive a lot of complaints about our rooms. That they're old and they look dirty, no matter what we do."

Kutzler says that St. Joseph's is trying to get a better "face in the community, but I've been here since 1990 and the community has always viewed this hospital as one that just takes care of the poor."

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2 comments on "HCAHPS Scores Show Wide Variation"


Linda Reiser (6/25/2012 at 3:57 PM)
I just read the article about HCAHPS which described the high and low scoring hospitals around the country. There was a quote which was a little disturbing. One of the rules surrounding HCAHPS says that hospitals should not in any way try to influence the scores. This includes using the language such as "always" which is the response we all want the patients to give! At Lehigh, a comment from CEO Joanie Jeannette is posted on the Lehigh's website: "We want to make sure that you are extremely satisfied with the care you receive. If at any time you are not satisfied with your care, please let us know. All of our staff is committed to achieving your standards of excellence. "Following your stay with us, you may receive a survey in the mail asking for your feedback. I hope you will take a few minutes to fill it out and let us know how we are doing. Again, it is both an honor and a privilege to serve you and we want to make sure we provide you and your family the very best of care... Always." We are told we should not use such language in order to be non-influential in the scoring. Does anyone else think this is influencing the responses unfairly?

Ardella Eagle (5/31/2012 at 9:51 AM)
As the CMMS swings over to using HCAHPS as a sliderule for payment reductions as suggested in the Affordable Care Act, you will see many of these 'demographically' challenged hospitals close down due to the inability to make ends meet. A very sad thing indeed. Using the general public as a measure on whether a provider should be paid is not a good idea. Pay for services rendered. Research if the service provided is being billed at a comprable rate and penalize the providers who are 'overcharging'. The current system of the fee schedule encourages physicians to bill the maximum allowed knowing that their fees will be reduced, then further cut due to contractual agreements.