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HCAHP Scores and the Patient Experience

Portrait of a doctor with two of her co-workers talking with a patient in the background

Have you recently been hospitalized or know someone who has?  You would have to say that there have been many improvements made over the past few years to accommodate the patient needs vs. the clinical needs.

Patient rooms use to be cold and uninviting with a lot of noise from PA systems or the hustle and bustle of activity in the hallways.  Today most patient rooms are tranquil, quiet and designed with single bed occupancy and easy of navigating through the room.  Hospital leaders are keenly aware that enhancing the patient experience has the potential to lift their bottom lines. A sign of the growing interest in this area is the widespread emergence of chief experience officers at a growing number of health systems.  Modern Health’s article, When a hospital patient is also a guest, addresses many of these top reasons why hospitals need to make changes. “The focus on improving the experience is clearly everywhere,” said Dr. Jim Merlino, president and chief medical officer at Press Ganey, who previously served as the Cleveland Clinic’s chief experience officer.

Why is this important? Medicare patients are being asked to grade hospital cleanliness, communication and other elements of their hospital stay which is then reported by to hospital leaders. The CMS began requiring hospitals to collect and report this information in 2007. In 2008, the CMS began publishing HCAHPS results. 

HCAHPS is just one piece of the broader transition to value-based payment. The Obama administration set the goal of tying 90% of spending in the traditional Medicare program to value by 2018, through a mixture of alternative payment models, quality measurements and financial penalties and incentives. Private insurers are attempting to do the same. 

Corresponding improvements

As shown in the AHA/ASHE report, several health care organizations have found that facility improvement projects have corresponded with improved patient experience ratings.

The organization’s approach to the issue involved facilities, operations, technology and equipment. This included opportunities to mitigate noise by installing sound-absorbing ceiling tile and quieter door latches, holding rounds in rooms instead of corridors, turning off TVs that aren’t in use, setting pagers to vibrate mode, lowering the unit telephone ring volume, and replacing casters and wheels on rolled equipment with quieter models.  Also included in the overall facilities scoring was nurse engagement.  How often did the nurse/caregiver listen to the patients needs?  Did they receive the proper level of nurse – patient engagement and respect? 

An article published by Health Facilities Management reported Ana Pinto-Alexander, RID, IIDA, EDAC, principal and group director for health interiors at HKS, and Upali Nanda, associate AIA, EDAC, associate principal and director of research for HKS, noting that the other publicly reported performance areas can be influenced by design. Caregiver communication, hospital staff members’ responsiveness to patient needs, pain management, the overall hospital rating and patients’ willingness to recommend the hospital — all areas covered by the survey — can each be affected by the design of a facility. For example, says Nanda, “If you set up the room in such a way that the patient can have a meaningful conversation with the provider and the family, that may have an influence on how they rate communication.”

Proximity has been designing wall mounted computer workstations for 25 years to accommodate the needs of caregivers while keeping the interaction with the patient our primary concern.  Our Classic and Embrace units offer a ease of access to data entry, as well as the ability to reposition the computer for a personalized experience.

I believe that we can all agree that there are many complex factors that contribute to a patient’s experience of care, but the physical environment can be significant component to a hospitals overall HCAHP score.