Why does it matter to hospitals if patients are satisfied with their care?
How does the patient’s experience impact healthcare organizations and their overall business?
These are just a few of the questions that have been asked by members in healthcare. If you have worked in the healthcare industry for more than ten years, you’ve more than likely personally observed the transition to standardized patient satisfaction measurement and reporting.
You may have even have some battle scars from the experience.
When patient satisfaction gained steam
I’ve worked in the healthcare industry for many, many years. I have worked various positions in the NICU, all of them rewarding and filled with their own sets of unique challenges.
I remember when the buzz around patient satisfaction started to hum in the background of what I knew as a regular (busy) work day.
I was working as a nurse manager in a large NICU when patient satisfaction was introduced to all leadership and management teams at my hospital. The discussion started as an introduction, a low hum in the far distance, something like a locomotive chugging along – but seemingly miles away from making its approach.
Meanwhile, I was busy and working on many projects, initiatives, and day-to-day activities of the unit.
It took a little while before I began to notice that patient satisfaction reports revealing patient experience had become a roaring freight train that was headed toward us, AND it was gaining speed. On board the train were new terms and language that included national averages, top boxes, scores, data, sample size, and comments from discharged families about their care.
Suddenly, patient satisfaction scores and results were being discussed in every leadership and quality meeting.
Lots of discussion centered around understanding the overall hospital score and individual unit score, and what did they mean? Finally, the most important question, how do we make them better? Although our results were not terrible, we were still expected to demonstrate improvement (improve on the current results).
Before too long, I was on a bullet train that was running at high level speed. I realized the families’ view of their hospital and NICU experience, and the care they received, had become the driving force in all priorities (yes, I do mean all).
I developed a stealth focus and attention to the information provided from the survey, and I am glad to be able to say that close attention to details, along with implementing initiatives, proved positive results.
As an example, one of the comments on a returned satisfaction survey was a mother expressing her concern that she wanted more breastfeeding support during her stay in the hospital. She eloquently detailed some of the challenges she was having post-discharge. Her comments provided crucial feedback that contributed to a detailed proposal for additional lactation support. Ultimately the request was successful, and added 0.5 FTE to our existing lactation team.
As time progressed, we began to see an increase in our scores. There were some ups and downs, but overall our hospital and unit scores improved.
Berkowitz wrote about the patient experience and the complexities of the concept. She highlighted the National Quality Forum, which reports “nursing leaders have put patient experience first on their list of organizational and patient care priorities.”2 Healthcare leaders report patient satisfaction in the top 3 on their list of priorities. Patient satisfaction and the patient’s view of their experience really does matter to hospitals.
It all began in 2005, with the enactment of the Deficit Reduction Act. This was intended to reduce costs by creating new incentives for hospitals to improve quality of care. A short while later, the Patient Protection and Affordable Care Act (ACA) of 2010 included patient satisfaction as one of the measures to be used for calculating value-based incentive payments in the Hospital Value-Based Purchasing program.3 In addition, the Centers for Medicare & Medicaid Services (CMS) got involved and added patient satisfaction results as an indicator for reimbursement.
The goal was to motivate health care facilities and providers to improve the quality of care they were providing, and improve patient outcomes. Publicly reporting individual hospital patient satisfaction scores was a key part of the initiative.
Patient satisfaction is used to measure quality in health care
In order to accomplish the goal, a high-quality survey tool was developed, along with robust requirements to guarantee quality reporting. The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is the survey instrument and data collection methodology that was developed and is currently used for measuring patients’ perceptions of their hospital experience.3 HCAHPS (also known as CAHPS) is the first national standardized survey instrument designed to capture and use for publicly reporting meaningful data about patient experience for comparisons to be made.3
The HCAHPS (CHAPS) survey was developed by the Centers for Medicare & Medicaid Services (CMS) and is a tool to measure the success of both doctors and hospitals. Results are available to compare the quality of local hospitals at www.hospitalcompare.hhs.gov.1
Hospitals are committed to improving the quality of care, and they demonstrate this commitment by providing, measuring, and understanding the experience from the patient/family perspective.
Patient satisfaction has become a key indicator used to measure the quality in health care
Now to answer the earlier questions: why is this important to health care systems, and why does it matter?
In addition to interest in improving quality of care and patient outcomes, there are additional incentives for hospitals to make satisfaction a priority:3,4,5
- Patient satisfaction is linked to customer loyalty
- Higher scores influence patient retention (satisfied customers tell others)
- Increase reimbursement (for hospitals and providers)
- Receive full Inpatient Prospective Payment Systems (IPPS) payment
- Eligible for managed care bonus
- Publicly reported scores for patients to compare
- Publicly reported scores are used for comparisons across hospitals locally, regionally, and nationally
Measurement of patient satisfaction is based on the perception of the patient’s experience.
After my years of working on advancing our patient satisfaction, I’ve realized it impacts so many things: not only the patients and families themselves, but our work as a team, our goals to improve patient care, and even the bottom line business aspect of running a hospital.
How has the advancement of patient satisfaction impacted your unit? Let us know in the comments section below!
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- Access the Hospital Compare Web site at medicare.gov/hospitalcompare
- Berkowitz, B. The patient experience and patient satisfaction: Measurement of a complex dynamic. OJIN. 2016; 21(1).
- Centers for Medicare and Medicaid Services https://www.cms.gov/medicare/quality-initiatives-patient-assessment-instruments/hospitalqualityinits/hospitalcompare.html
- Prakash, B. Patient Satisfaction. J Cutan Aesthet Surg. 3(3):151-155.Quality of care and patient satisfaction scores can impact your hospital business.