HCAHPS

HCAHPS scores Closely Tied to Readmission Rates

Posted on March 28, 2013. Filed under: Admission & Discharge, Communication, HCAHPS, Patient Experience |

ImageWith Medicare payment penalties for excess readmissions now in effect, reducing readmissions has become a top priority for hospitals and other stakeholders. The Centers for Medicare and Medicaid Services (CMS) publicly reports risk-adjusted readmission rates for heart attack, heart failure and pneumonia. The data shows significant variation in performance across hospitals, indicating that some hospitals are more successful than others at addressing the causes of readmissions. A recent study by Press Ganey suggests that performance on readmission metrics is associated with performance on patient experience of care measures.

Press Ganey analyzed hospitals’ readmission penalty data in the context of their scores for CMS’ Hospital Inpatient Value-based Purchasing program (VBP) to determine if there was a relationship in performance on the two pay-for-performance programs. The VBP program establishes scores for both the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey results and process of care measures. The study found a demonstrated negative association between hospitals’ HCAHPS VBP scores and readmission penalties; as hospital performance on HCAHPS increased, readmission penalties decreased. Very low HCAHPS performance (scores of 0–19 was associated with much-higher-than-average readmission penalties, and very high HCAHPS performance (80–100) was associated with much-lower-than-average readmission penalties.

These findings support previous research on the link between patient experience and clinical quality found that higher overall patient satisfaction and satisfaction with discharge planning were associated with lower 30-day risk-standardized readmission rates. This current study seems to suggest, HCAHPS scores, not clinical measures, were more closely linked to readmission rates.

To effectively combat patient readmissions, hospitals can benefit from a foundational strategy that starts first and foremost with the patient – and efforts that are aimed at improving HCAHPS scores are an excellent initial step. The majority of the HCAHPS survey questions address communications between caregivers and patients. Effective communications is fundamental to ensuring that patients become engaged in their care and, consequently, better equipped to follow discharge instructions and self-monitor after leaving the acute care setting.

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Healthcare 101: How HCAHPS Works

Posted on March 1, 2013. Filed under: Government and Healthcare, HCAHPS, Patient Experience, Post By Christy Whipple |

How HCAHPS Works 

 

ImageHCAHPS is part of Medicare’s value-based purchasing program, created as an effort to initiate reimbursement models that pay for a high quality of care rather than a high quantity of care. HCAHPS is a survey that measures patient satisfaction with the entire hospital experience.

Recently discharged patients are asked to answer 27 questions that are used to measure their perception of the quality of care they received in the hospital.

The HCAHPS survey includes seven key areas: responsiveness of hospital staff, nursing communication skills, physician communication skills, pain management, quietness and cleanliness, explanations about medications and discharge instructions. The survey is designed to allow objective and meaningful comparisons between hospitals in areas that are important to consumers. Results are published online and can be viewed by the public.

The data is used to determine reimbursement. Hospitals can gain or lose up to two percent of their Medicare reimbursement fees, depending on how well they score. A hospital that chooses not to participate in HCAHPS is automatically docked two percent.

HCAHPS survey data has been collected and tallied since October 2012. The Centers for Medicare and Medicaid Services (CMS) began implementing value-based incentive payments for hospitals this year.

 

To learn more about HCAHPS and how Introcomm can help you raise your scores and lower the risk of reimbursement penalties, contact us

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Guide for Nurses During Admission and Discharge

Posted on February 17, 2013. Filed under: Admission & Discharge, Communication, HCAHPS, Introcomm Services, Post By Christy Whipple |

Nursing-AdmissionThere are many things to consider when admitting or discharging a patient in a health care facility. Introcomm can assist healthcare facilities with numerous admissions and discharge objects, especially focusing on clear and concise communication between the healthcare staff and the patient/family.

The following checklist, inspired by a nursing school lesson plan from the Texas Education Agency, contains suggestions and recommendations for guiding a patient through a smooth admissions and discharge process. Please contact us to learn more about utilizing our customized communications toolkit.

Greeting the Patient

Specific admission procedures will depend on the policy of the healthcare facility, however many of these recommendations are relevant for most hospitals and facilities. In some healthcare facilities, the patient is taken directly to the room, where the actual admission process begins. Most facilities, however, start the admission process in the admitting office. A preliminary interview of the patient is done to obtain the necessary medical and financial information.  It is important for the family to remain with the patient for this interview.

The First Impression

1. Greet each patient in a friendly, cheerful manner.
2. Introduce yourself, and take the patient to their room.
3. If the patient has a friend or relative with him/her, invite them to accompany you to the room.
4. Introduce the patient to other healthcare providers in the room.

Communication Throughout the Admission Procedure

Statistics show that HCAHPS scores are improved when healthcare providers help the patient become familiar with the new surroundings. Even simple explanations can help the patient feel more connected and cared for by the hospital staff.

1. Explain the facility’s policy on visitors, and the use of the television and telephone.
2. Demonstrate how to use the signal cord system, remote-control television and automatic bed controls.
3. Tell the patient when meals are served.
4. Answer any questions he/she has about scheduled procedures and daily rounding.
5. Comfort the patient by showing him/her where personal items are stored
6.  Make a list of the clothing and personal items the patient has, have the patient or a member of the family sign the list, give a copy to the patient and to the nursing supervisor to include in the patient’s chart.

Communicating With Family During Admission

1. Create an atmosphere of warmth and understanding for the patient and the patient’s family.
2. Always be courteous and helpful to the patient and the patient’s family.
3. Kindly communicate with family members during times when they may be required to leave the room.
4. Promptly alert the family when they may return to the patient’s room.
5. If the patient is unable to answer the admission questions, have a family member help you with the information needed

Planning for the Patient’s Discharge

There are many things to consider when planning for the patient’s discharge.  If the illness has not been long, complicated, or severe, there may not be special preparations other than general health instructions and information concerning the actual discharge (such as the time and date the patient will be discharged).  For other patients, the discharge process is more complicated. The patient’s attitude towards discharge and continued progress toward recovery must be considered. If being discharged to home, the patient may need reassurance that recovery will continue at home.

The nurse should make sure the patient has been given instructions by the doctor for home care and understands the instructions for:
1. Taking medications
2. Exercise programs
3. Physical therapy
4. Changing dressings
5. Giving injections
6. Respiratory treatments that will be continued at home.
* If possible, the nurse should give the patient a written copy of the instructions, such as a copy of the diet or an appointment card for a return visit to the doctor

Patient care does not end when the patient is discharged. The patient may receive visits from a home health agency to supervise the care and treatment.  The patient’s home care should make use of existing community resources so the patient and the family will not have to undertake the financial and emotional burden. The patient may be concerned about being able to manage for himself/herself.  These worries may keep the patient from looking forward to leaving the healthcare facility. The patient may wonder what kinds of treatment, if any, will be needed at home and how it will be done. Provisions for special nursing care, such as provided by visiting nurses, may be needed for the patient who is unable to manage his/her own hygiene and personal care.  An important consideration may be whether help will be required for meals, grocery shopping, etc., for a patient living alone and how long such help will be needed. 

Visit us at www.introcomm.com to learn more and to request your FREE educational webinar.

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Improve Patient Experience to Reduce Readmissions

Posted on February 4, 2013. Filed under: Communication, HCAHPS, Patient Experience, Post By Christy Whipple, Readmission |

Christy Whipple

According to a research study released by Press Ganey Associates, Inc., hospitals that perform better on patient experience measures also have lower patient readmission rates.

blurry hallway

Reducing Readmissions: A Top Priority

With Medicare payment penalties for readmissions now in effect, reducing readmissions has become a top priority for hospitals and other stakeholders. The Centers for Medicare and Medicaid Services (CMS) publicly reports risk-adjusted readmission rates for heart attack, heart failure and pneumonia. A new study by Press Ganey suggests that performance on readmission metrics is associated with performance on patient experience.

HCAHPS Performance Related to Readmission Rates

Sources suggest that many hospitals struggle to identify and address the factors that influence readmissions. However, the Press Ganey study has revealed a strong connection between lower rates of excess readmissions for certain conditions and higher performance on Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) value-based purchasing metrics.

Start with a Focus on the Patient

Nell Buhlman, Press Ganey’s VP of Product Strategy states, “”Readmissions and HCAHPS are multifaceted… To effectively combat patient readmissions, hospitals can benefit from a foundational strategy that starts first and foremost with the patient – and efforts that are aimed at improving HCAHPS scores are an excellent initial step.”

When HCAHPS Increase, Readmissions Decrease

The Press Ganey study found that as hospital performance on HCAHPS increases, readmission penalties decrease: Very low HCAHPS performance (scores of 0-20) was associated with much-higher-than-average readmission penalties, and very high HCAHPS performance (80-100) was associated with much-lower-than-average readmission penalties.

Engage Patients in Their Care

According to a related article written by David Harlow JD MPH, effective communications “is fundamental to ensuring that patients become engaged in their care and, consequently, better equipped to follow discharge instructions and self-monitor after leaving the acute care setting.”

Communication Reduces Readmissions

Harlow also suggests that hospitals adopt a sustainable discharge strategy that identifies and addresses “patient-specific factors that could lead to readmission, strategic patient education, developing a patient-focused after-care plan and ensuring a smooth transition to a post-acute setting.” In summary, he states that “a patient-centered discharge planning process, built on clear communications with the patient, is likely to reduce readmissions.”

 

 

Are you ready to improve your patient perception 
experience and reduce your readmission rates with improved communication? Introcomm provides custom communications solutions beginning with the admissions and discharge processes. Find out how we can help you improve communication by improving systems you already have in place (meaning little to no additional out of pocket expense). 

Contact us today to schedule our complimentary educational webinar.
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Patient Satisfaction Can Be EASY…?

Posted on January 24, 2013. Filed under: Communication, HCAHPS, Patient Experience, Post By Christy Whipple |

Christy Whipple
“You call them small things, but I call them easy things. There’s no reason they shouldn’t be fixed…” 

Patient satisfaction is based on what? Patient perception.

Clinton Memorial Hospital CEO Mark Dooley said conversations with patients revealed when they are dissatisfied, it is typically not with clinical quality. Their discontent is with response time to answering a call light, limited communication from the nursing staff, lack of personal connection with the hospital staff. All of these add up to cause a patient to perceive that he is not valued.

Small Things = Easy Improvements

Dooley claims that this perception is not only in hospitals’ control, but one of the easier things to fix. “You call them small things, but I call them easy things. There’s no reason they shouldn’t be fixed,” Dooley said. “I know there’s some image rebuilding we need to do. We have to take care of those needs, do the right things, treat patients the right way.”

Communication Improves Perception

Patient satisfaction and patient centered care go beyond patient needs and incorporate what patients perceive as quality of care. Effective and fluid communication between patients, patient families, and nursing staff, as well as staff efficiency and accessibility, play key roles in determining how patients view their stay at your hospital, and whether they will recommend your facility to their friends and loved ones. Poor communication or miscommunication, as well as lack of staff attention are highly detrimental to patients’ perception of quality of care.

Stay Focused

On the surface, communication appears to be a simple concept within health care. Patients talk to doctors, nurses, and staff members. Doctors explain treatment options to patients. However, obstacles often get in the way of understandable, quality communication. A lack of quality communication limits the quality of service that can be provided to the patient. Some of these issues are rooted within healthcare system design, while others are the result of misplaced focus. Although quality care is important, in some case the perception of care is equally important. According to a study performed in Jackson, Mississippi, the level of patient satisfaction, perceived quality and communication directly correlated with symptom improvement and healing.

Cornerstone of the Healthcare Relationship

Healthcare is a relationship and communication is the cornerstone of every successful relationship.  Encourage staff to communicate one-to-one with patient and family members. Improved communication will improve patents perception, satisfaction and quite possibly the healing process. Communication is an inexpensive and easy measure. The key is to remember the importance of communication and make it a high priority. Every hospital can benefit immensely by improved communication.

Are you ready to improve your patient perception with improved communication? Introcomm provides custom communications solutions beginning with the admissions and discharge processes. Find out how we can help you improve communication by improving systems you already have in place (meaning little to no additional out of pocket expense).

Introcomm can certainly help you improve communication, but we can also assist your hospital with HCAHPS, patient experience, reduced readmission rates and more.  Contact us today to schedule our complimentary educational webinar.

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Patient Experience Goes Beyond Medical Care

Posted on January 10, 2013. Filed under: Communication, HCAHPS, Patient Experience, Post By Christy Whipple |

Christy Whipple

“Hospitals will have to venture beyond the traditional realm of merely providing world-class medical care.” 

Although 92% of hospital leaders claim to rate patient experience among their top three priorities, it seems no one quite knows what to do or how to improve it. Patients are less forgiving of poor service than they once were, and their expectations are continually rising because of the continually improving customer service offered by other kinds of service providers. A survey done by HealthLeaders found that 41% of patients indicated they would be willing to switch hospitals for a better patient experience.

Good Intentions
The majority of healthcare systems’ mission statements reflect that improving the health of patients is the primary mission. This being the case, then understanding and improving the patient experience must be an important focus. And it would seem that healthcare leaders would be experts at improving the patient experience. However, often this is not the case.

Beyond Medical Care
Hospitals will have to venture beyond the traditional realm of merely providing world-class medical care. They must approach patients as customers, and design the end-to-end patient experience accordingly. This willmove the focus of a hospital’s capabilities from purely clinical competencies to those that also cover customer management.

Customized Communication
The US Medical Center successfully implemented several innovations that have improved the customer experience, especially in terms of information consistency, access, communications and personalized service.The medical center found thatbased on age groups, patients have different needs and preferences, as well as different attitudes and expectations, when it came to their overall patient experience. The younger patients, for example, preferred to pull information when, where and how they wanted it. Older patients, on the other hand, were more interested in having information pushed to them and readily available. Older patients also preferred printed media vs. digital.

Benefits of Satisfied Patients
More satisfied patients bring numerous benefits for hospitals. Satisfied customers often cost less to serve. They consume resources more efficiently.They are more likely to recommend the hospital to friends. They are more likely to give the hospital high ratings, resulting in higher reimbursement rates.

In a healthcare setting, there is an added benefit to satisfied customers: they are more likely to develop good health habits, such as following wellness regimens. They are more tuned into messaging from healthcare providers and, therefore, more likely to make follow-up appointments, take prescribed drugs and keep up with recommended screenings. In other words, they work with their healthcare providers to prevent illness rather than just seek treatment after illness occurs. This preventive approach can dramatically reduce the costs associated with medical care.

More than Patient Satisfaction
The patient experience is more than just patient satisfaction. It incorporates all aspects of the patient’s interaction with the healthcare system. The patient experience includes patient satisfaction, patient engagement, and the quality of the care. To improve the patient experience, leadership needs to focus and truly make the patient experience a priority.

Introcomm provides custom communications solutions for the admissions and discharge processes. To learn more about how Introcomm can assist your hospital with HCAHPS, patient experience, and improved communations (with little to no additional out of pocket expense), please contact us today to schedule our complimentary educational webinar.

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Creating Your Patient Experience Program: Where to Begin

Posted on December 27, 2012. Filed under: Communication, HCAHPS, Patient Experience, Post By Christy Whipple |

Christy Whipple

“…Weave The Patient Experience into the very fabric of your organization’s culture.”

building-a-planThere are plenty of ways to make patient experience more than just another initiative, according to a recent article in HealthLeaders Media. “..To weave it into the very fabric of your organization’s culture, and ultimately to reap the rewards of a healthier bottom line and a reputation that people will talk about with anyone who will listen.”

Does Your Staff “Get It?”
The HealthLeaders article further states that about 95% of the hospitals are current with the latest buzzwords. When asked about ‘patient experience,’ they’ve got it. ‘Service excellence?’ They’ve got it. But Dr. Gnida asks, “Do they really? When we talk to managers who are writing action plans   or directors who are frustrated that they can’t move their scores or grow   their market, it turns out that they’re not really doing service excellence work, which is creating remarkable experiences. Usually they’re doing service   recovery work instead. I don’t want to denigrate service recovery, but it’s a whole other strategy-it’s not patient experience.”

Where Should You Begin?
How will you stay engaged and aligned? How will you know whether the activities are improving the patient experience? Start with a performance analysis accounting for the HCAHPS metrics. This can help an organization understand the current performance along each of these measurements. Deficiencies in any of these areas provide insight on areas to focus improvement efforts. These measures also provide a baseline and a framework for ongoing assessment of the organization’s progress.

Developing a Plan
An execution plan should mimic a road map. It should include the high level work plan, goals, projected timeline, estimated resources and additional support areas required to implement the road map. Throughout implementation and thereafter, the organization can return to the original analysis metrics to assess its performance. This analysis will provide ongoing guidance for prioritizing the activities that may have a significant impact on the Patient’s Experience.

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A Letter to Dr. Santa

Posted on December 19, 2012. Filed under: Communication, HCAHPS, Introcomm Services, Patient Experience, Post By Christy Whipple, Readmission |

  Dear Dr. Santa,

  Please bring us happy and engaged patients,
  higher HCAHPS scores, awesome communications tools,
  lower readmission rates and higher reimbursements.

  Sincerely,
  Holly Jingle
  Director of Patient Experience
  North Pole General Hospital

.
If these items are on your wish list, this is one webinar you can’t afford to miss! 

Are your hospital’s HCAHPS scores less than ideal? Are you missing out on valuable reimbursements? Is patient perception out of line with your patient experience efforts? If you answered ‘yes’ to any of these questions, let us share this beneficial information with you. 

Free Educational Webinar!
The experts of Introcomm would like to engage you in a complimentary, one-on-one, educational webinar: “The Patient Experience Puzzle.” Our goal is to provide insight, identify impact points and deliver a go-forward strategy to improve the Patient Experience. This could prove to be the best 20 minute investment you’ll make this year!

Enjoy a Starbucks Coffee Break – It’s on Us!
Introcomm is happy to treat you to a delicious Starbucks treat to thank you for scheduling a webinar. Sit back, relax and enjoy a hot cup of holiday coffee as we present our educational webinar.*

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We know that everyone has hectic schedules, especially around the holidays. So, we’re making it easy. Simply indicate the date and time you would like to engage in the webinar, and one of our experts will be happy to accommodate your schedule. Click Here

* A five dollar Starbucks eCard will be emailed to attendees upon completion of the 5 question survey accompanying webinar confirmation

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Healthcare 101: Exchanges

Posted on November 28, 2012. Filed under: Government and Healthcare, HCAHPS, Post By Christy Whipple |

Each state electing to establish an Exchange must adopt the federal standards in law and rule, and have in effect a state law or regulation that implements these standards.

Again this week, the U.S. Department of Health & Human Services has extended the deadline for states to decide whether they will create and run a health insurance exchange. States have until December 14th to alert HHS if they will establish their own exchange. If so, they also must submit a blueprint for the system. This is a hot topic, but do we really understand the principles of the Exchange? This breakdown provides an overview of the key components.

Creation of Health Insurance Exchanges

Beginning on January 1, 2014 health insurance exchanges will be created where an individual or small business can compare the costs of various health plans and different types of health coverage benefits. If a state decides not to operate its own health insurance exchange, residents who are U.S. citizens and legal immigrants will be eligible to purchase a health plan from a multi-state, or regional exchange run by a government agency or a non-profit organization.

Individual State Exchanges

Each state electing to establish an Exchange must adopt the federal standards in law and rule, and have in effect a state law or regulation that implements these standards. If a state elects not to establish an Exchange, or if the HHS determines on review that state efforts to establish an Exchange have not made sufficient progress to be fully operational by January 1, 2014,  the ACA requires the Department of Health and Human Services (HHS) to establish and operate one in that state.

Qualified Health Plans (QHPs)

Exchanges should be designed to provide qualified individuals and small businesses with access to an insurers’ QHPs. QHPs are described in the ACA as a type of health plan that is subject to a specified list of requirements related to marketing, choice of providers, plan networks, essential benefits, and other features. QHP issuers will have to be licensed by each state in order to be eligible to provide coverage within their boundaries, and offer at least one QHP at the silver or gold level of coverage.

Multi-State Health Plans

Each health insurance exchange must offer at least two health plans that are available in two or more states. At least one of these health plans must be a non-profit organization and be licensed in each state. Enrollment in one of these plans would give access to healthcare services in different states.

Consumer Operated and Oriented Plan

The health reform bill will provide loans and grants to create non-profit, member-run health insurance companies known as Consumer Operated and Oriented Plans (CO-OPs).

One-Stop Shopping and Information Resource

An anticipated benefit of the health insurance exchanges is easier to purchasing and enrollment in a health plan or health coverage for employees. The health reform law recommends that states contract with “navigators” to provide information about the available health plans and to assist with enrollment.

Affordability 

If a resident cannot afford to purchase a plan in an exchange, they may be eligible for a subsidy from the government based on your income and family size. If yearly income is higher than 133% of the federal poverty level but less than 400% of the poverty level (about $43,000 for an individual), individuals will get a tax credit to help pay for health plan’s premiums and out-of-pocket expenses.


Introcomm provides custom communications solutions for the admissions and discharge processes. To learn more about how Introcomm can assist your hospital with HCAHPS, patient experience, exchanges and improving your patients’ perception of quality care (with little to no additional out of pocket expense), please contact us today to schedule our complimentary educational webinar.

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Hospital VBP: HCAHPS Insights

Posted on November 6, 2012. Filed under: HCAHPS, Post By Christy Whipple |

Patient Experience of Care Domain accounts for 30% of the Total Performance Score for 2013 and 2014
Christy Whipple

HCAHPS and VBP have likely been very popular acronyms discussed among the staff in your hospital over the past few months. Beginning with inpatients discharged in October 2012, HCAHPS performance will now account for 30 percent of the Hospital Value Based Purchasing (VBP) Total Performance Score in Fiscal Year (FY) 2013 and FY 2014. This has caused HCAHPS and VBP to become a primary focus for many hospital administrators. Most hospitals have provided trainings and lectures to prepare for this change; however a recent polling showed that 73% of hospital employees still do not have a clear understanding of the HCAHPS process. The following information is intended to provide additional insights into the latest progression of the HCAHPS process.

How is VBP Measured? The Total Performance Score for Hospital VBP in FY 2013 will have two components: the Clinical Process of Care Domain, which accounts for 70% of the Total Performance Score; and the Patient Experience of Care Domain, which accounts for 30% of the Total Performance Score.

What is the HCAHPS Survey? HCAHPS, which stands for Hospital Consumer Assessment of Health Providers and Systems, is a government survey for measuring patient satisfaction at hospitals across the country. The HCAHPS survey is the basis for the Patient Experience Domain regarding Total Performance Score for Hospital VBP. The intent of the HCAHPS initiative is to provide a standardized survey instrument and data collection methodology for measuring patients’ perspectives on hospital care.

Which Elements are Covered by the HCAHPS Survey? The following HCAHPS dimensions are used in Hospital VBP: Communication with Nurses, Communication with Doctors, Staff Responsiveness, Pain Management, Communication about Medicines, and Discharge Information, Hospital Cleanliness and Quietness, Overall Rating of Hospital.

What is the Patient Experience of Care Domain Score? The Patient Experience of Care Domain Score is the sum of the HCAHPS Base Score (0 – 80 points) and HCAHPS Consistency Points score (0 – 20 points), thus it can range from 0 to 100 points. As noted earlier, the Patient Experience Domain comprises 30% of the Hospital VBP Total Performance Score.

More information about Hospital VBP is available at the new CMS Website.

Introcomm provides custom solutions for the admissions and discharge processes which assist with each element of the HCAHPS survey. To learn how we can improve your scores with little to no additional out of pocket expense, please contact us today to schedule our complimentary educational webinar: connect@introcomm.com or www.introcomm.com/contact.aspx

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