Explore - Summer 2013 - (Page 11)
ON THE ENVIRONMENT
The Hospital Consumer Assessment of Healthcare Providers and Systems
now includes a new composite: cleanliness and quietness. How can your
hospital boost its scores?
By Carl Solomon, Sr., MBA, CHESP
ince 2008, the HCAHPS—Hospital Consumer
Assessment of Healthcare Providers and Systems—
survey has allowed valid comparisons across hospitals locally, regionally, and nationally. Starting
last October, HCAHPS scores resulting from patient
discharge surveys are being used in the calculation
of value-based incentive payments in the Hospital Value-Based
Purchasing (VBP) program. The HCAHPS survey asks recently discharged patients about aspects of their hospital experience that
they are uniquely suited to address. The core of the survey contains
18 items that ask “how often” or whether patients experienced
a critical aspect of hospital care, rather than whether they were
“satisfied” with the care. The survey also includes four items to
direct patients to relevant questions, three items to adjust for
the mix of patients across hospitals, and two items that support
Inpatient Prospective Payment System: funds at risk
Since July 2007, hospitals subject to the Inpatient Prospective
Payment System (IPPS) annual payment update provisions must
collect and submit HCAHPS data in order to receive their full annual
payment update. IPPS hospitals that fail to publicly report the
required quality measures, which include the HCAHPS Survey, may
receive an annual payment update that is reduced by 2 percent.1
HCAHPS & hospital Value-Based Purchasing (VBP) Scoring
The Hospital VBP program links a portion of IPPS hospitals’
payment from the Centers for Medicare & Medicaid Services (CMS)
to performance on a set of quality measures. The hospital’s total
performance score (TPS) for FY 2013 has two components: the
clinical process of care domain (70 percent of TPS), and the patient
1. HCAHPS Fact Sheet (CAHPS Hospital Survey), May 2012
experience of care domain (30 percent of TPS). The HCAHPS survey
is the basis of the patient experience of care domain.1
Eight HCAHPS measures are employed in the hospital VBP:
the six HCAHPS composites (communication with nurses, communication with doctors, staff responsiveness, pain management,
communication and medicines, and discharge information); one
new composite that combines the hospital cleanliness and quietness survey items; and one global item (overall rating of hospital).
The percentage of a hospital’s patients who chose the most
positive, or “Top-Box,” survey response in these HCAHPS dimensions is used to calculate the patient experience of care domain
score. Below are details about what hospitals are doing to improve
their Top-Box score1 on the cleanliness and quietness survey item.
For cleanliness, the patient is asked the following question:
“During this hospital stay, how often were your room and bathroom kept clean?”
Departments that are responsible for cleaning patients’ rooms
are having their staff perform the following duties:
• Having a supervisor or manager check in on every newly admitted patient the same day they are admitted, if possible.
• Retraining their cleaning staff on how to properly clean an
occupied patient room and bathroom.
• Using bleach-based germicidal cleaners or alcohol-free germicidal cleaners to help the room smell clean.
• Removing trash and soiled linen at the start of the day, and
making a second round in the evening after dinner is served.
• Conducting a sample of daily room inspections before and after
the room has been cleaned.
• Rotating the order of occupied room cleaning (e.g., the first
room cleaned on a given day is not the first room cleaned the
www.ahe.org I EXPLORE I Summer 2013 11
Table of Contents for the Digital Edition of Explore - Summer 2013
Managing the Engagement Driver
The Crucial Role of the Environment
HCAHPS: Ways to Improve on the Environment Question
AHE News & Updates
Explore - Summer 2013