Hospital patient experience surveys, such as the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), measure the quality of care given by a hospital, which influences patient satisfaction and retention. Patient experience scores directly correlate to profitability, determining reimbursements and bonuses that hospitals receive from insurers, commercial payers, and government programs like Medicare. Additionally, patient experience surveys provide actionable feedback to hospitals to improve patient satisfaction and perceptions of care.
These surveys can also help hospitals identify opportunities to improve care delivery and avoid larger problems. Therefore, patient assessments should be conducted regularly and examined in tandem with clinical outcomes when measuring the performance of a hospital against its peers.
An Honest Path Of Discovery Starting With A Poll
Recently, we conducted a poll focusing on HCAHPS scores aimed at a variety of health care professionals within hospitals all across the US. We asked the audience a very simple question: “Is your hospital actively seeking ways to better improve HCAHPS Scores through Patient Experience?”
We found the results to be not terribly surprising and they are listed below.
Let’s look at five ways hospitals can impact their HCAHPS scores by improving patient satisfaction:
- Provide Clear Patient Discharge Information
Patient Information Discharge Plans (PIDs) with clear and concise information, as well as updated contact information for follow-up care, can significantly improve patient satisfaction scores. Patient experience surveys demonstrate that patients want to leave the hospital having a solid understanding of their discharge plan, including information about their medication, education materials, home health referrals, and follow-up appointments.
The Institute of Medicine’s report, “Crossing the Quality Chasm,” states that effective handoffs are vital to high quality patient care. Patient discharge packets can be overwhelming to patients who are already struggling with the transition out of the hospital environment. Providing detailed, cohesive instruction manuals rather than loose documents help patients transition back into their normal lives after discharge. When readmission rates drop, everyone is happy.
- Increase Patient Engagement
Patient engagement requires open, honest communication that empowers patients. The more involved a patient is in their own healthcare decisions, the better their satisfaction scores will be. Including the patient in their care plan by opening a dialogue to address questions or concerns and educate them on the reasoning behind their suggested care plan is an easy way to achieve higher levels of satisfaction.
Patient participation in shared decision making, including setting treatment goals together with physicians, receiving explanations of care plans, and understanding test results has been correlated with improved HCAHPS scores (Patient Empowerment). According to All American Home Care, there are simple ways to improve patient engagement, such as making a personal connection by inquiring about subjects outside of their care instance. Personalized questions and small talk builds trust and shows that you care about their wellbeing in general, which encourages a positive doctor-patient relationship and removes potential barriers to patient engagement.
- Improve Patient Room Cleanliness
It should be no surprise that patient room cleanliness is a major driver of patient satisfaction. Three HCAHPS questions are related specifically to the bathroom! Therefore, hospital cleanliness has a significant impact on patient satisfaction scores, with lower scores correlated to dirty rooms. Patient perception of room cleanliness is also an important predictor of future hospital return visits. While some hospitals may be focusing on how to provide the best “hotel” experience in their paternity ward, a simple fix for most hospitals would be setting up intervals to ensure the bathroom is well equipped, accessible, and always clean.
- Make Patient Pain Management a Priority
Patient dissatisfaction often stems from pain management concerns during recovery or end-of-life care. Patient experience surveys demonstrate that patients are very dissatisfied when they do not receive effective pain control, including post-operative patients and those in emergency/trauma departments. Like other aspects of care, pain management is graded on a five-point Likert scale ranging from “never” to “always.” Patient experience surveys indicate that low ratings for pain management correlate with overall dissatisfaction and higher ratings when their pain is managed effectively. While pain management through medication is an assessment that would be best handled by the patient’s care team, there are a few ways to address this through effective communication.
Managing Pain and Improving Comfort (Johns Hopkins) suggests introducing a 0 to 10 pain scale to open an avenue of communication about pain management. Another suggestion is to address other comfort areas while a patient is in the hospital by providing a menu of items you can offer to increase their comfort.
Suggested items you can offer patients to improve comfort:
- Warm/cold packs
- Warm blankets
- Warm washcloth
- Extra pillows
- Bed repositioning
- Walk down the hall (if appropriate)
- Shower or bath
- Appropriate stretches
- Special food, snacks, or beverages
- Visits from a chaplain or social worker
- Soothing music
- Guided imagery therapy
- Personal grooming items
- Improve Patient Communication and Responsiveness
Patients appreciate medical professionals who listen to them, prioritize their concerns, and communicate openly about treatment options. Patient experience surveys also indicate that responsiveness of care has a significant impact on satisfaction scores, with lower scores correlating to physicians who do not appropriately respond to patient needs. Patient communication is the cornerstone of care during a hospital visit. Fortunately, technology, tools, and simple best practices can help address this.
Sara Health’s 4 Best Practices for Improving Patient-Provider Communication suggests being clear about using any patient portals or technology which may give the patient access and involve them with their own care plans. Notably, when a provider communicates about patient technologies, such as patient portals, it also leads to a higher adoption rate and involvement in care.
One way to increase responsiveness and open lines of communication is through the use of patient-facing technologies. For instance, introducing a telehealth program allows patients to have their concerns addressed quickly in the event of an emergency or without the pain of having to leave the comfort of home.
Another way to improve responsiveness is to put the paperwork aside by introducing an eSignature Platform that saves the patient and clinician time. Advanced eSignature technologies today can ensure that paperwork, such as registration or informed consent, is complete before a visit. Alternative to paper and scanning forms, real-time patient form technology can ensure 100% completion, improve accuracy (with the opportunity to verify information), eliminate the risks associated with missing paper consents, and reduce the chance that the patient has to repeatedly write down the same information. For clinicians, using eSignature Platform technology through workflows can automatically provide physician reviewed consent content with the latest risks, in a variety of languages and grade levels to ensure informed consent is optimized.
Using empathy during patient communication is pertinent to break down barriers between patients and their care teams, and this correlates directly with better patient satisfaction rates. Instead of staring at a computer during a care visit, use technology to help, such as Dragon One dictation services. According to the JAMA study, Association Between Clinician Computer Use and Communication With Patients in Safety-Net Clinics, higher computer usage during a patient visit directly correlates with lower patient satisfaction and poorer communication. Consider using technology to automate patient information collection tasks and maximize the time spent with the patient.
Patient satisfaction is a crucial factor in HCAHPS scores, and improving patient perception of care is within reach through clear discharge information, increased patient engagement, improved room cleanliness, effective pain management, and improved communication and responsiveness. Introducing techniques and technology to break barriers, open communication, and establish trust is the keystone to a positive patient experience. Using some of the techniques above, while not conclusive, provides a simple plan of action that any hospital can adopt.
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