4 Best Practices for Boosting Your HCAHPS Scores
September 26, 2017
Dollars are on the line more than ever this year for hospitals and health systems when it comes to the patient experience: In 2017, HCAHPS* scores determine up to 2 percent of Medicare payments. Plus, patients are becoming savvy consumers and may decide where to receive care based on hospitals’ star ratings on Hospital Compare, where HCAHPS scores are published and compared to the state and national averages by the Centers for Medicare & Medicaid Services (CMS). With hospitals’ financial health and reputation on the line, many are looking for strategies to boost their HCAHPS scores.
This is true for the growing numbers individuals and families opting for high deductible plans, too. When patients are on the hook for thousands of dollars in medical expenses, you can be sure they pay close attention to how they’re treated as they receive care.
Every patient interaction with clinical and non-clinical care team members can influence how they fill out that all-important survey after they’re discharged. Here are four ways technology can help improve care team response and collaboration to provide the best patient experience possible:
1. Rapid Response
One of the 11 HCAHPS measures is “responsiveness of hospital staff.” Since public reporting began, the average response has increased from 60 to 69 percent. That’s a nice jump, but there’s further improvement needed, and technology can help inform clinicians when and where they need to take action.
Poor communications can negatively impact the quality and speed (“responsiveness”) of patient care. For example, if calls for assistance go to a central nursing station, someone must track down the nurse assigned to that patient, relay the message, and finally, respond to the patient.
Hospitals can cut out these time-consuming steps with software that sends request notifications from the patient’s nurse call button directly to the correct caregiver’s mobile device. The nurse can then directly connect to the patient’s pillow speaker to determine the need. If the patient just wants a glass of water, the nurse might direct it to a non-clinical staff member to fulfill that request. If the patient is in pain, he’ll respond directly and immediately. A speedy response to a patient request cuts stress and increases satisfaction.
2. Nix the Noise
The “quietness of the hospital environment” frequently ranks lowest among the HCAHPS survey categories, as it did in the most recent report from CMS. While that figure has improved nearly 10 percent, it remains among the lowest-ranking survey categories. Research indicates the importance of sleep and plenty of rest to the healing process. Yet we know hospitals can be noisy places with numerous beeps, overhead paging, and hallway conversations.
Among the biggest noise culprits are patient monitoring alarms, whose sounding frequency can lead to clinician alarm fatigue, a patient safety hazard. While critical alarms should never be disabled, hospitals can reduce their frequency. Programming device parameters to trigger alerts only when an actionable threshold is reached is one way to reduce false positives that disrupt patient rest.
Mobile device notifications are another way to promote a quiet environment for rest and healing. Integrated call notification and staff assignment systems reduce overhead paging by routing patient alarm notifications directly to appropriate staff. Mobile devices also enable secure messaging among care team members, which cuts down on hallway conversations—improving information security and minimizing patient disturbance.
3. Palliate Pain
The longer patients are in pain, the unhappier they’ll be. Yet communication problems can cause many delays to alleviating pain. An important first step to help minimize the delay is to ensure the patient receives a fast response to the nurse call button. A good system will route alerts to the primary nurse or escalate the request to another clinician if the primary nurse is unavailable.
An existing order in the patient’s chart allows the nurse to administer pain relief right away. But if no order exists, the nurse must consult with the patient’s physician. An efficient communication system helps the nurse locate the physician quickly via an online enterprise directory and on-call schedules, and then use secure texting to send the request for additional pain medication. The physician can either enter an order immediately or call the nurse for more information.
4. Drama-free Discharge
When patients are ready for release, they expect a smooth and efficient discharge from the hospital. Communication breakdowns among the care team cause unnecessary delays and leave patients with a poor experience before they exit through the hospital doors and fill out the HCAHPS questionnaire. Secure messaging streamlines the discharge process by sending messages from the patient’s EHR, while taking advantage of the staff directory and on-duty/on-call status to reach the entire team. Clinical care team members can communicate and agree that discharge today is OK, then non-clinical care team members like transport, environmental services, and even the valet can be notified to prepare for the patient’s departure and the next patient’s arrival. Patients are able to leave sooner and happier.
While hospitals have done much to improve HCAHPS scores, there’s still a long road ahead. Patient satisfaction is influenced by many factors, but at the core of nearly every interaction with hospital staff is communication. Communication technology can help improve the patient experience by quickly connecting everyone involved in patient care, including the patient.
* HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) Survey is the first national, standardized, publicly reported survey of patients' perspectives of hospital care.
By Dr. Nat’e Guyton, RN, MSN, CPHIMS, NE-BC
Dr. Nat’e Guyton is Spok’s Chief Nursing Officer. She is a nurse and clinical leader with over 15 years of healthcare and technology experience that includes clinical workflow redesigns, EHR and health IT implementations, and pursuing interoperable, patient-centric, and user-friendly technology for quality outcomes. Guyton holds a bachelor’s and master’s degree in nursing, post graduate degrees in healthcare administration and healthcare informatics, and a doctorate in management-organizational leadership. She is an advocate for patients, for nurses, and for healthcare organizations.