HCAHPS and Case Management
Daily case managers and social workers strive to meet the needs of the patients and families, treatment team, and hospital. Therefore, we as leaders must give them the tools to excel and recognize them for their endeavors. When they excel and feel valued for their work, everyone benefits, particularly the patients and families. That becomes especially evident when our team knows and understands the purpose and value of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS).
I encourage you to reflect on your teams’ understanding of HCAHPS and the processes to support excellent discharge planning and transitioning of care. Does your team understand which dimensions or domains their work supports? Do they know the specific questions HCAHPS asks that relate to their daily practices? Does the team realize the importance of HCAHPS as it relates to reputation, quality, and reimbursement? Is there tracking and monitoring of HCAHPS results? Is this information shared with the Utilization Review Committee? Are there action plans in place when the results are trending in a southerly direction?
It is a starting place for the journey. By the way, do you know your facility’s star rating for Discharge Information and Care Transitions dimensions? Here’s the information if you would like to discover it: "Survey of Patients' Hospital Experiences" section of the Hospital Compare Web site (https://www.medicare.gov/hospitalcompare).
HCAHPS Stars Ratings Distributions for October 2019 Public Reporting (N= 3502 Hospitals)
(https://www.hcahpsonline.org/ Centers for Medicare & Medicaid Services, Baltimore, MD. Retrieved 12/11/2019)
Below is a beginner’s primer to the HCAHPS.
HCAHPS is a standardized national publicly reported survey on patients' views of the care they received during their recent hospitalization. This survey is endorsed by the Centers for Medicare and Medicaid (CMS) and the National Quality Forum (NQF). The survey has three goals:
1. The survey is designed to produce data about patients' perspectives of care that allow objective and meaningful comparisons of hospitals on important topics to consumers.
2. The public reporting of the survey results creates new incentives for hospitals to improve the quality of care.
3. Public reporting enhances accountability in health care by increasing transparency of the quality of hospital care provided in return for the public investment. (Retrieved from https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HospitalQualityInits/HospitalHCAHPS.)
The survey is comprised of several dimensions with corresponding questions ranging from care received from nurses and physicians to the patient’s perception of the hospital’s cleanliness and quietness. There are two dimensions (and the associated questions) Case Managers and Social Workers’ daily role and processes impact:
• “When you left the hospital” or more commonly known as the Discharge Information
o During this hospital stay, did doctors, nurses, or other hospital staff talk with you about whether you would have the help you needed when you left the hospital?
o During this hospital stay, did you get information in writing about what symptoms or health problems to look out for after you left the hospital?
• “Understanding your care when you left the hospital,” otherwise known as Care Transition
o During this hospital stay, staff took my preferences and those of my family or caregiver into account in deciding what my health care needs would be when I left.
o When I left the hospital, I had a good understanding of the things I was responsible for in managing my health.
o When I left the hospital, I clearly understood the purpose for taking each of my medications.
Good luck. Let me know how the primer works out for your organization, along with the practices you found to be effective.