HCAHPS

IMPROVING PATIENT EXPERIENCE

BY
IMPROVING CAREGIVER
RESPONSIVENESS
MARGARITA SMITH
RN CNIII
9 GARDEN SOUTH
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A UNIT PERFORMANCE IMPROVEMENT
PRESENTATION
HCAHPS
WHAT IS HCAHPS?
HCAHPS is an abbreviation for Hospital Consumer
Assessment of Healthcare Providers and Systems and
it is a performance measurements standard of improving
patient care from the patients perspective.
HCAHPS is a core set of questions that can be combined
with a broader, customized set of hospital-specific items.
HCAHPS survey items complement the data hospitals
currently collect to support improvements in internal
customer services and quality related activities.
HOSPITAL CONSUMER ASSESSMENT OF HEALTHCARE PROVIDERS SYSTEMS
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WHY IS IT IMPORTANT TO MEET
THE HCAHPS STANDARDS ?
To offer patients the best possible care in a
healthcare setting.
To remain consistent in providing quality
patient care.
To improve performance of patient care by
staff members.
To maintain consistent quality care from all
staff members throughout the entire hospital.
To improve hospital overall HCAHPS Scores.

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EXAMPLES OF HCAHPS SURVEY
QUESTIONS
RESPONSIVENESS OF STAFF: How often did you get help in getting to the bathroom?
Or in getting a bedpan as soon as you wanted?
During this hospital stay, after you pressed the call button, how often did you get help as
soon as you wanted it?
COMMUNICATION OF DOCTORS:
During this hospital stay, how often did doctors treat you with courtesy and respect?
During this hospital stay, how often did doctors listen carefully to you?
During this hospital stay, how often did doctors explain things in a way that you could
understand?
CLEANLINESS OF HOSPITAL ENVIRONMENT: During this hospital , how often were
your room and your bathroom kept clean?
QUIETNESS OF HOSPITAL ENVIRONMENT :During this hospital stay , how often was
the area around your room quiet at night?
PAIN MANAGEMENT: During this hospital stay, How often was your pain well
controlled?
During this hospital stay, how often did the staff do everything for you to help you with
your pain?

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BEST PRACTICES FOR IMPROVING THE
PATIENT CARE EXPERIENCE
1) Hourly Rounds-nurses should inquire of patient needs
during rounds. Best practices hourly rounding has a
significant positive impact on patient experience.
Increased trust=stronger caregiver-patient relationship.
Improves pain management
Improves safety and efficiency of care
2)Responding to patient call button quickly.
Inquiring if patient would like to go to the bathroom
3) Monitoring patient pain management.
Consistently inquiring of patients needs.
4) Communicate with staff at bedside change of shift report.

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BEST PAIN MANAGEMENT PRACTICES
IN RELATION TO HCAHPS SURVEYS QUESTIONS
During this hospital stay, How
often was your pain well
controlled?
Respond to patients pain and
evaluate effectiveness of pain
medication
During this hospital stay, how
often did the staff do everything
for you to help you with your
pain?


Effectively Monitor the patient
from the pain scale
HCACPS PATIENT
QUESTIONS
BEST HEALTHCARE PRACTICES
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BEST HOURLY ROUNDING PRACTICES
IN RELATION TO HCAHPS SURVEYS QUESTIONS
How Often did you get help in
getting to the bathroom or in
using the bedpan as soon as
you wanted?
Consistent responsiveness to
POTTY, PAIN and POSITION
Did someone from the hospital
check on your care and comfort ?

Notify patient, I am here to do
my hourly rounds with you
Remind the Patient that you are
ALWAYS there to help.
ALWAYS be respective and
courteous to patients at all
times.
HCAHPS PATIENT
QUESTIONS
BEST
HEALTHCARE PRACTICES
Statistics show,
that Consistent
hourly Rounding
reduces patient
falls by 52%!
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CALL BELL RESPONSE BEST PRACTICES, IN
RELATION TO HCAHPS SURVEY QUESTIONS
During this hospital stay,
after you pressed the call
button how often did you
get help as soon as you
wanted?
Always respond promptly
to the call button
Any staff member can
respond to the call bell
Always fulfill call requests as
soon as possible.
HCAHPS PATIENT
QUESTIONS
BEST
HEALTHCARE PRACTICES
ANY STAFF MEMBER
CAN RESPOND TO
CALL LIGHT
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IMPROVING HCAHPS SCORES BY
IMPROVING PATIENT CARE
Improve pain scores
Patient satisfaction improvement
Improve safety
Improve hourly roundings
Change of shift bedside
Engage all staff answer call light
Change of shift bedside report
Monitor patient care outcomes through
evidence Based practices
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YEAR TO DATE MONTHLY HCAHPS SCORES BY UNIT
UNIT 2012 NYP
2013
GOAL
UNIT
2013
GOAL
JAN FEB MAR APR MAY JUN JUL AUG
6 HN 56 73 75 62.5 66.7 60 57.1 70 100*
6 GN 57 73 63 59.6 76.2 52.3 50 72.7 50*
6 GS 54 73 61 85.7 54.8 56.3 66.7 50 80
7 GS 66 73 67 78.6 66.7 61.1 76.8 50 78.6
9 GS 65 73 57 75 76.8 63.4 60 56.2 74.3
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YEAR TO DATE QUARTERLY HCAHPS SCORES BY UNIT
TOPIC DISCUSSION ACTION/FOLLOW UP
Review of Quarter to date scores Unit Target QTR
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QTR 2 YTD (*)-N of 6
6 HN 73 62.5 70 66.1
6 GN 63 60.7 59.9 60.2
6 GS 61 65.3 66,7 65.9
7 GS 67 69.8 73 71
9 GS 57 65.5 64.5 65
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HCAPS RESPONSIVENESS TARGET FOR 9 GARDEN SOUTH

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
66.1 48.6 52 47.2 55.0 61.
9
50
1
st
Quarter 2
nd
Quarter 3
rd Quarter


4
th
Quarter
58.8 54.7
UNIT OVERALL
HCAPS SCORE
TARGET: 50
REFERENCES
Ford, R.et al, Methods of Measuring PATIENT SATISFACTION
Health Care Management ,Spring 1997,22 (2)pp.74-89
Malloch, K and Porter OGrady,T. INTRODUCTION OF EVIDENCE
BASED PRACTICE IN NURSING AND HEALTHCARE , Jones and
Bartlette Inc.,2006
Meade c.m. et al. effect of nursing rounds on patient call light use.
Satisfaction and Safety American Journal of Nursing, September
2006,106 (9),pp 58-70
Winsett, rp and cashion, a.k. THE NURSING RESEARCH PROCESS.
NEPHROLOGY NURSING JOURNAL November-December 2007,34(6),
pp 635-643
National Patient Safety Foundation,Bedside Change of Shift
Reporting: A strategy to Increase Patient Safety, NPSF Professsional
Learning Series October 19,2011
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HCAHPS
READ AND SIGN
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