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HCAHPS Scores for Hospitals: Where the Opportunity for Improvement Lies

Improving scores on a hospital consumer assessment like the HCAHPS survey and providing the best care are objectives not always completely aligned. Patient satisfaction can be improved by elements unrelated to healthcare or that spend hospital funds unwisely. Some patient requests can even worsen their outcomes. Unnecessary amenities in rooms, along with misguided pain management requests and unwarranted tests, fall into these categories.

A Consumer Assessment of Healthcare: The Positives

So is a consumer ever a good term for a hospital patient?

Considering the main publicly reported assessment of healthcare providers in hospitals, the HCAHPS survey isn’t going anywhere, “consumer” it is.

A positive aspect of the HCAHPS survey is it captures healthcare providers’ and systems’ strengths and shortcomings. It measures skills that are hard to gauge otherwise. These include the clarity and consistency of communication with providers, amount of empathy, cleanliness and quietness of the hospital environment.

The HCAHPS Survey and Communicative Shortcomings

Publicly reported HCAHPS scores to provide insight into communicative shortcomings. Empathy doesn’t come naturally to everyone. The skill of breaking medical information into intelligible parts must be learned sometimes. Even those with natural communicative skills are prone to slipping in demanding environments like hospitals.

So how can the hospital environment, with the unwieldy number of factors influencing HCAHPS results, improve communication about medicines, symptoms, discharge information and other areas of HCAHPS hospital care?

The answer is multifaceted. However, many hospitals have blind spots emitting low scores. The financial ramifications dealt with by the Centers for Medicare and Medicaid Services call for delving into both conventional and lesser-known solutions.

Maintaining Quality Despite Incongruence with Patient Opinions

If patient requests, like those for extra or unneeded medications or treatments, don’t line up with their best course of treatment, then better conversations can show patients their erroneous thinking. Likewise, better communication can address patient requests that inconvenience the comfort or health outcomes of other patients.

For example, some people’s machines must beep in a hospital. Some patients’ will to push through is influenced by their visitors, who may be chatty for morale purposes.

A different but related facet of HCAHPS results is communicative consistency. Patients can spend less time worried, in pain, needing help or seeking their own health information if providers visit more often. Up-to-date information on their status and frequent conversations about medicines help patients cope.

When 37% of the questions on the HCAHPS survey deal with communication, it’s important to keep talking to the anxious and uncomfortable.

Common Communicative Recommendations

To improve HCAHPS scores, consultants recommend measures to improve communicative consistency and depth:

Improved rounding procedures that reduce call button usage help the provider network in a certain unit or ward. The overall responsiveness of hospital staff climbs when minor or routine needs remain minor. A regular bathroom visit shouldn’t be classified as emergent. Situations should be categorized by urgency. Hospital systems should then be sensitive to degrees of urgency. Proactive rounding with firm yet empathetic dialogue upholds classifications of urgency. It can help with the HCAHPS measure of the quietness of the hospital environment too.

An example of a blended tactic that can impact HCAHPS scores is when physicians and nurses round together. It helps even more to have a standardized conversation protocol guiding conversations. It improved scores overall, but communication with doctors improved more.

Of course, if improving provider availability was easy, it wouldn’t be such a notorious problem. Hospitals can’t just crank up a dial on the number of nurses or physicians. Many factors complicate efforts to lower the provider-to-patient ratio.

So what other options get patients to recommend the hospital and improve HCAHPS scores?

Communication Skills to Improve Assessment of Healthcare Providers

Consultants in hospital quality sometimes recommend improving providers’ social and information delivery skills.

Communication with Doctors and Providers

  • Provider listening skills make hospital patients feel understood when their full gamut of concerns is at least considered, if not addressed. Sometimes patients wait days to speak to doctors. They hope to be heard.
  • Consistent displays of empathy, especially in communication with nurses, can have surprising leverage on the results of a patient satisfaction survey.
  • Improving the delivery of medical information helps with the HCAHPS survey. Small chunks, digestible in terms of medical sophistication and emotional capacity for bad news, can help with the overall rating of hospital care.
  • Communication with nurses can be improved on the patient’s side with proactive information. A “welcome card” upon admission can set expectations for the responsiveness of hospital staff. The methods, frequency and reasoning being rounding procedures appear on such a hospital welcome card.
  • Digestible communication about medicines and pain management improves patient outcomes.

A Blind Spot in Communicative Strategy

While efforts to improve general patient-provider dialogue can boost a consumer assessment of healthcare if conversations were outstandingly poor across the board, they may not be the wisest use of hospital resources. Such expenditures may make less impact than targeting those who likely suffer poor communication. Those who would prefer to speak to providers in their native language but can’t, or can’t consistently, cannot be ignored.

Influence on Healthcare Providers and Systems’ Reputations

The expense of consultation services to devise strategies to boost HCAHPS scores, combined with the costs of implementation and maintenance, can be prohibitive. That’s especially so with technological improvements.

Is the expense of taking conversations from “great” to “terrific” worth it for HCAHPS scores? With additional patient contact may come more expense-incurring requests.

Meanwhile, groups of patients receiving poor communication can cause average HCAHPS scores to sink. Those who’d prefer speaking in their first language but must try English may represent a bigger improvement opportunity.

Non-native-speaking patients sometimes suffer from intermittent interpretations or none at all. This area can be a hospital’s blind spot in terms of the patient experience. The results can emerge in formal or informal public reporting.

These unclear or infrequent messages represent an untapped potential to improve a patient satisfaction survey like the HCAHPS. Best of all, language services don’t incur a blanket cost regardless of usage. A comprehensive language solution, like hospital interpreting, is billed on an on-demand basis.

Proactive LEP Measures

A hospital doesn’t want patients to first fully express themselves after the situation cannot be rectified. The HCAHPS survey is printed in Russian, Vietnamese, Chinese and Spanish (also available via phone). The survey shouldn’t be their first chance to relate their negative experiences.

Cultural Considerations

Culture can also impact a patient’s willingness to voice their discomfort or dissatisfaction. Other cultures are less likely to call nurses or make negative face-to-face evaluations of their patient experience. However, after pain or neglect is compounded, they might express the true nature of their hospital experience on their HCAHPS survey.

Improving HCAHPS Survey Results with Proactive Language Solutions

Choosing a language company that understands hospitals’ need to improve HCAHPS is a secure bet. Many small, local interpretation providers do not see the big picture.

ALTA Language Services, Inc. understands the complexity of factors affecting hospital communications. It also understands where the opportunity for communicative improvement lies. Furthermore, ALTA’s quality management system is ISO Certified. This means it has received international validation to a degree that only 5% of companies achieve.

Medical interpreting is a very demanding skill. Medical terminology can muddle the recall and language conversion processes. Training, experience and professionalism matter in interpreting. For over thirty years, ALTA has provided an array of professional language services, including medical interpreting.

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