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HCAHPS: Update for Trustees Mary Therriault RN MS Senior Director, Quality and Research Initiatives Healthcare Association of New York State July, 2012. HRET Curriculum: A New Way of Thinking about HCAHPS. H ospital C onsumer A ssessment of H ealthcare P roviders and S ystems.

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HRET Curriculum: A New Way of Thinking about HCAHPS

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HCAHPS: Update for TrusteesMary Therriault RN MSSenior Director, Quality and Research Initiatives Healthcare Association of New York State July, 2012

HRET Curriculum: A New Way of Thinking about HCAHPS



Assessment of


Providers and


What HCAHPS Means


Can you



Patients/ Providers


AHRQ/HRET Patient Safety Learning Network (PSLN) Project

  • HANYS, HRET and AHRQ are partners in bringing you this free program of technical assistance for 6 months.

  • AHRQ has retained HRET to partner with health care leaders in creating Patient Safety Learning Networks to support hospitals that wish to use AHRQ’s patient safety improvement tools.

  • HRET will support learning network members in using HCAHPS, as well other AHRQ patient safety tools in 25 States during 2012.


  • This program is supported by the U.S. Agency for Healthcare Research and Quality (AHRQ) through a contract with the Health Research and Educational Trust (HRET).

  • HRET is a charitable and educational organization affiliated with the American Hospital Association, whose mission is to transform health care through research and education.

  • AHRQ is a federal agency whose mission is to improve the quality, safety, efficiency, and effectiveness of health care for all Americans.

  • Faculty: Carrie Brady, MA, JD

    • Primary HCAHPS trainer

    • Former Connecticut Hospital Association staffer

    • Previous V.P. at Planetree

HCAHPS and HEN Priority Challenges: Care Transitions and Adverse Drug Events

Top four HCAHPS Priorities of over 430 hospitals participating in 18 HCAHPS PSLNs:

  • RN Communication

  • Responsiveness

  • Medication Communication*

  • Discharge Information*

    * HCAHPS domains addressed by a patient-centered discharge process

Our Goal

To support hospital teams in effectively using HCAHPS as a tool for improving quality, safety, and the patient experience.

Our Strategies

  • Provide expertise, research, and practical tools

  • Harness participants’ institutional wisdom

  • Build internal teams and external communities for ongoing improvement work

Pop Quiz!

In the United States,

how many HCAHPS surveys:

Will be administered today?

Will be completed today?


More than 25,000 surveys administered

More than 7,500 surveys completed

More than 7% of all hospitalized patients

complete the survey

Source: HCAHPS Executive Insight, October 2011. hcahpsonline.org. Centers for Medicare & Medicaid Services, Baltimore, MD. http://www.hcahpsonline.org/Executive_Insight/.

HCAHPS In a Nutshell

  • HCAHPS is a national standardized survey of hospital inpatients

  • 27 questions

    • 18 substantive questions

    • 4 screening questions

    • 5 demographic questions


  • CMS reports individual scores for:

    • Cleanliness

    • Quiet at night

    • Overall rating

    • Willingness to recommend

  • CMS reports composite scores for 6 topics:

    • Nurse Communication

    • Doctor Communication

    • Medication Communication

    • Responsiveness

    • Pain Management

    • Discharge Information

Patients See Things Differently Than Providers

Source: Weingart SN et al. “Patient-Reported Safety and Quality of Care in Outpatient Oncology” Joint Commission Journal on Quality and Patient Safety; 33:2, 2007

22% of 193 patients reported a “recent unsafe episode”

More than 80% of the reported experiences were classified by reviewers as “service quality incidents”

  • 33% related to waits and delays

  • 21% related to poor communication and information for patients

  • 13% related to poor coordination of care among staff

The Evidence is Mounting

HCAHPS Matters


HCAHPS Strategies Implemented by 25 Hospitals in Learning Network

Why HCAHPS Matters:

Value-Based Purchasing Implications

VBP Overview

  • DRG payments initially reduced by 1% in FY2013

    • reduction rises by 0.25% each year, ending with 2% reduction in FY2017

  • Payments adjusted based on performance on HCAHPS (30%) and clinical process measures (70%)

  • Hospitals may earn VBP points in two ways:

    • By achieving a certain level of performance or

    • By improving their performance

    • More points available for achievement than improvement

How Are We Doing?

New York Top Priorities for Improvement

Essential Elements to Consider

  • Leadership Strategies

  • Strategies for Partnering with Patients and Families

  • Workforce Strategies

  • Data Use Strategies

  • Performance Improvement Strategies

Ideal Scenario

HCAHPS is viewed as a valuable tool to help organizations achieve multiple objectives

HCAHPS is part of a coordinated, comprehensive approach to partnering with patients and families

Everyone works together as a team to identify opportunities for improvement, innovate and implement strategies, and celebrate success

Improving Communication through Team Training


  • A comprehensive evidence-based system to enhance teamwork and communication among healthcare professionals

  • HRET is the national training contractor

  • Free curriculum and tools available at http://teamstepps.ahrq.gov/index.htm

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