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How Strong and Multilingual Communication Can Boost HCAHPS Scores

Improving HCAHPS scores is an invigorating challenge for some hospital administrators. For others, and at some point for most, it’s a frustrating task. Hospitals are complex environments, and personal experiences are subjective.

One reason this assessment evokes frustration is that HCAHPS survey questions account for an unwieldy number of factors, many of them subjective. Most opinion questions deal with patient satisfaction with staff communication and responsiveness. Human and social factors can be beastly to control in any environment, let alone in a busy hospital. Nevertheless, focusing on strong and easily accessible communication does wonders for patient satisfaction scores.

Providers and Hospital Compensation

Although it’s not often noted, in hospitals, a complicated relationship exists between healthcare providers, the price of healthcare and reimbursement from CMS. Many providers chose to work in hospitals because they can just focus on care. Headaches about insurance payments, patients’ ability to pay and prescription costs don’t often clog hands-on providers’ bandwidths.

Nevertheless, the HCAHPs survey brings the relationship between quality for patients and financial concerns to physicians, nurses, pharmacists and others. Improving patient satisfaction, partly through overcoming the social-skill challenges sometimes present in busy, science-oriented environments, is not easy. However, planning for consistent, clear and empathetic communication at a hospital-wide level goes a long way toward patient satisfaction levels that improve HCAHPS scores.

Beyond Reimbursement – Communication on the HCAHPS Survey

It’s not that providers already don’t prioritize achieving great patient experience levels throughout their hospital stay and afterward. Many take pride in doing so. Nevertheless, some do not regularly give patient-centric care, or cannot while operating in overworked systems.

In a different vein, some regions of the U.S. just aren’t as courteous or caring. Imagine the typical exchanges of a New York City nurse compared to one in a small town in the South or Midwest. Still, in any area, poor communication, lack of empathy or insufficient communication can have severe ramifications. Luckily, some hospitals adopt scripts to improve and standardize the language. Questions for nurses and doctors to ask can determine the need for patient education, which can raise any HCAHPS score.

Impact of the Few Unsatisfied Patients

A hospital may feel great about its environment and HCAHPS survey answers. Or it may be like the feedback on any consumer assessment of healthcare. If the hospital is giving three out of four patients, who are sick or injured and potentially very uncomfortable, a good patient experience, that seems acceptable.

However, an HCAHPS score is a percentile. A 75% might be reasonable, but the Centers for Medicare and Medicaid compare that score to other hospitals. Scoring better than 50% of hospitals is the true benchmark. Reimbursement depends on the percentile. Therefore, unsatisfactory communication from a few providers, when enumerated as a percentile, can have a profound impact on consumer assessment of healthcare.

The Care in Healthcare

An unremarkable but still important effect of poor communication is that patients can be truly suffering or getting neglected. Poor patient care is the enemy of a hospital, any way you slice it. Dissatisfaction and failures in educating patients can be publicly reported. When a hospital gets a bad reputation, patients with chronic health issues will find a way to go elsewhere. They may even switch insurances or HMOs. Patient communications and education play a huge role in the quality of care. Clear and consistent communication helps put care in healthcare.

Improving HCAHPS Scores to Lower the Threat of Malpractice Suits

The communicative focus of the questions on the HCAHPS doesn’t just help with reimbursement. It’s also a lever on the soft skills of that hospital’s providers. Poor communication & listening skills intersect with the risk of malpractice suits. That’s because communication is a factor in many malpractice suits. If a hospital’s providers aren’t communicating clearly or consistently, or don’t show enough concern or empathy, the financial and procedural penalties can arrive in other forms besides a lack of CMS reimbursement. A standardized survey and numeric HCAHPS scores can reveal providers’ misguided approaches to patient dialogue. It can prevent failures in the patient’s room before more patients and families consider a malpractice suit.

Hospital Reimbursement

Of course, HCAHPS scores affect reimbursement. Low scores are detrimental to hospitals’ reimbursement. While there are many ways to show the impact of lesser reimbursement, we’ll take one widespread issue as an example. Communication about patients’ transition out of the hospital and post-discharge plans is vital. If providers do not communicate well about where the patient is headed upon discharge, the availability of help, medication and treatment regimens, and future symptoms, it can result in patients’ quick readmission. If hospitals do not control the quality of a discharge, they are penalized.

Leverage of Communication on Patient Satisfaction Scores

It is unpleasant to think the patient experience is being improved simply for compensation purposes. Luckily, that’s not the case. Unless someone is thrilled about delivering a baby, hospital admittance is just an upsetting and painful experience. Of course, providers want to help patients and families through illness and injury, regardless of future HCAHPS survey answers.

Clear and consistent communication is a big part of a positive patient experience. Providers want them to understand their diagnoses, treatment options, and their current status. Communication is also vital to managing pain.

Therefore, it’s no surprise that the following verbiage appears on the HCAPS survey:

  • “…treat you with courtesy and respect?”
  • “…listen carefully to you?”
  • “…explain things in a way you could understand?”
  • “…tell you what the medicine was for?”
  • “…describe possible side effects in a way you could understand?”

Overall, 10 of the twenty-seven questions on the HCAHPS survey deal with communication. That is 37%. However, the leverage of communication-based questions in determining patient satisfaction with the hospital’s healthcare providers and systems is much higher. That’s because several questions simply gather information. For example: “. . .were you given any medicine that you had not taken before?” and “What language do you mainly speak at home?” are used to collect data. They determine for which experiences patient satisfaction can be assessed. Communication is where the efforts to improve patient satisfaction scores should be concentrated before and while a patient is leaving the hospital.

Ultimate Effects on HCAHPS Scores

Patient care should be a hospital’s top priority. Penalties can put a hospital in a negative feedback loop. It’s harder to solve the problems causing the penalties without the financial resources the penalties confiscated. Communication comprises a vital component of many an HCAHPS score gauging patient satisfaction, aside from those that just collect the occurrences in the patient experience.

Communicative assessment of healthcare providers is crucial. The HCAHPS survey succinctly gauges patients’ perception of providers’ communicative thoroughness and care. This perception is subjective. Yet the risk of greater ramifications in the form of the hospital’s reputation and even malpractice suits can be assessed with the HCAHPS survey. One less subjective area of communication is improving foreign-language situations.

A High-Impact Improvement for HCAHPS Scores: Language Services

In terms of a controllable factor in patient satisfaction with communication, expanding foreign language access can be a straightforward and highly effective way to improve HCAHPS scores. It’s less subjective and less variable. Hospitals have busy days. Departments get restructured or have staff turnover. One associate’s bad day can spread among providers. However, language access can reliably improve HCAHPS scores across the board. Seldom-cited but effective strategies to clear communicative channels are cultural training and accent-reduction training.

Anticipating Diversity

Forming a language-access plan in all patient-facing domains can have a great impact on the patient experience. In the U.S., we’re preparing for a globalized world. We’re serving one of the most diverse populations in the world, which is diversifying at an increasing pace. The U.S. is also driving globalization. This long-standing haven for immigrants also has an entrepreneurial spirit that pushes for faster, stronger and wider-reaching services. Diversity is here to stay. This should factor into tactics for improving HCAHPS scores and measures to improve patient education.

Language-Access Plan Considerations

Speed & Ease

The bottom line in a hospital is that doctors have many patients to see. Nurses often round. Hospital staff always have something to do. So if contacting an interpreter isn’t quick and easy, hospital staff will work around doing so. They’ll wait for bilingual staff members to get free. They’ll entrust their message to more proficient family members. They may even whip out their phone for Google Translate. It’s understandable they must make do for LEP patients and deaf patients. With their pressing need to continue to other patients, the surest way to properly relay information to patients sooner for the sake of quality and HCAHPS scores is a quick connection to medical interpreters.

Diversity Training for Improving HCAHPS Scores

Staff needs to know that providing great native-language communication is crucial not just for patient satisfaction, but also for improving HCAHPS scores. Although patients may be proficient in English (or Spanish), people strongly prefer high-impact exchanges in their native tongue. Patients crave native-level clarity for their healthcare, banking, legal concerns and high-priced purchases.

True, they might have to take their healthy ten-year-old to a monolingual, English-speaking pediatrician. However, care for an issue severe enough to warrant hospital admission merits hospital staff who are aware of diversity issues and willing to use language services to reach patients and families.

Familiarity & Training

Healthcare providers have a lot of protocols to follow aside from HCAHPS-score-raising behavior. Adding language services as an option doesn’t guarantee they’ll be used. To ensure the best patient experience, providers should be familiar with the process to access interpreters and translators. Beyond providing a phone number, staff should receive initial training. Periodic training should follow if they don’t routinely access it. The training should include a trial run using an interpreter.

Language Services’ Impact on Care

Language services can positively impact care and improve patient education. However, quality, accessibility and reliability play a large role. For that reason, larger, more experienced language-service companies should be entrusted instead of local providers. They can offer multiple modes of interpretation. Companies with a reservoir of interpreters can meet higher-volume and short-notice requests.

Severe consequences result from a scheduled medical interpretation or translation that the linguist misses. Hectic schedules are the norm among doctors and other healthcare providers. Therefore, reliability is key, along with diverse access modes. Improving patients’ outcomes HCAHPS scores is easier with reliable language services.


Providers lose vital control over the quality of the speech once they need an interpreter. Therefore, they need professional, knowledgeable interpreters. It’s important for patient satisfaction scores that the interpreter is thorough and sensitive. HCAHPS-score efforts can be multiplied by great medical interpreters.

Many people do not realize interpreting is a highly demanding skill. It drains cognitive energy. It pulls from extensive linguistic knowledge. Medical interpreting draws on a continually evolving wealth of healthcare terminology in two languages.

Experienced medical interpreters won’t get mentally bogged down by the interaction and can convey the following:

  • the provider’s emotion (or even a needed emotion): empathy, curiosity, concern
  • the most detailed information patients are capable of absorbing
  • ability-appropriate medical terminology

Experienced medical interpreters are also capable of the following:

  • quickly comprehending patients’ different dialects and accents of their languages
  • determining the risks of potential linguistic errors relating to patient care
  • having professional standards high enough to not take linguistic shortcuts
  • having ethical standards high enough to not surpass their knowledge in order to seem competent
  • discerning what sick patients are trying to say (they may mumble or groan)

Hopefully, it is evident that excellent interpreters are indispensable to missions to improve any assessment of healthcare providers, especially patients’ opinions that evolve into HCHAPS score trends.


Experienced medical translators are also indispensable to improving HCAHPS scores. In particular, they can play an important role in helping staff members deliver intelligible post-discharge plans to patients in their native language. The chances of getting readmitted can spike sharply . . . if patients and families can’t determine how to continue navigating their illness or injury after their hospital stay.

Great medical translators are connoisseurs of medical terminology. They work while enmeshed in a team at a robust language service provider. The teamwork improves their quality. It’s much easier to achieve medical wordsmith status with teamwork and larger companies’ linguistic resources.

Like stellar medical interpreters, great translators also have high professional standards. Translators often offer higher quality linguistic exchanges than interpreters, since the exchange isn’t done in real-time.

Medical translators’ ethical standards are also high. They understand the detriment of vague or incorrect translations. A good medical translator never feeds their ego at the expense of the patient’s experience or health. In sum, great medical translators help improve HCAHPS scores, particularly in lowering readmission rates.

ALTA Provides Quality of Care through Language

ALTA Language Services Inc. (ALTA) doesn’t just provide high volumes of medical language exchange services. We understand hospitals’ drive to improve HCAHPS scores based on communicative HCAHPS survey questions. ALTA relishes assisting efforts to improve the experience of patients throughout their hospital stay and post-discharge. Hospital consumer assessment scores needn’t suffer due to language barriers.

Medical Interpretation

In hospitals, medical interpretation is usually more in demand than translation. ALTA meets hospitals’ diverse and complex needs with four different modes of interpreting.

ALTA offers an on-site interpretation. Both consecutive and simultaneous interpreting is available in many languages.

Telephone Interpretation (OPI) is a great option for medical situations. ALTA offers over 200 languages. With less than a one-minute connection time, 24 hours per day, we’re the only telephonic provider needed to improve HCAHPS scores. We’re happy to complete one-time or intermittent interpretations.

Our Video Remote Interpretation (VRI) puts a personalized touch on linguistic exchanges. It’s able to capture expressions and body language. It’s also great for those who may need written support or sign language.

Remote Simultaneous Interpretation (RSI) helps during real-time video calls.

Medical Translation

ALTA only employs native-speaking translators. We use the best combination of human translators with duplication-avoidant technology to reduce prices for human translations. Improve HCAHPS scores, and any hospital consumer assessment measures, without incurring extra costs elsewhere.

Accent Reduction

A seldom-utilized service among healthcare providers and systems that are highly recommended is accent reduction. It’s overlooked for foreign-born or bilingual physicians, nurses and staff. A hospital may have an excellent provider with a great speech, in terms of content. However, if patients don’t understand their accents or form a positive impression of them, their expertise is impeded. It can result in low HCAHPS scores.

Granted, breaching the accent-reduction topic with hospital staff is not easy. Take it from ALTA, associates are proud of their second or third language, as they should be. Achieving proficiency is a hard fight. However, when offered as an opportunity that can get busy, overworked providers off the hospital floor to train as part of continuing education, it becomes more easily accepted. Committed providers are often willing to train to improve patient satisfaction.

Some providers may not be aware of their accent or how strong it still is. Actually, more-foreign-sounding pronunciation can be standard in some communities. For example, imagine a bilingual Spanish doctor near the border in El Paso or Miami. So many people there have learned English as an additional language that the English commonly spoken in the community may have tinges of Spanish pronunciation. The provider has no reason to reduce their normal accent. However, if that doctor moves to Maine or Minnesota, people unaccustomed to a Spanish accent may struggle to understand.

Choose ALTA to Boost Patient Satisfaction Scores

Regardless of the language you need, ALTA will provide experienced medical linguists. From medical interpreters to translators, to trainers in provider and patient education, we can help execute a multi-pronged approach to improving any HCAHPS score or any assessment of healthcare providers.

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