Journal of Healthcare Management - January/February 2014 - (Page 43)

t H e v alue of p atIents ' H andwr Itten c o MMents data to make decisions. Furthermore, the numerical ratings sometimes do not show much difference between hospitals, especially when ratings are combined and reported as aggregate scores, making it difficult for consumers to see the value in hospital report cards such as HCAHPS and discouraging them from using the information to make decisions about hospital providers (Hibbard, Greene, Sofaer, Firminger, & Hirsh, 2012). When such ambiguity exists, consumers engage in heuristic decision making, in which anecdotal information plays a more important role, and people rely on hearsay from friends and relatives (Fagerlin, Wang, & Ubel, 2005; Huppertz & Carlson, 2010). Increasing evidence shows that people like to write comments when they give feedback on surveys and that consumers rely on those comments to make purchase decisions (Chen & Xie, 2008; Chevalier & Mayzlin, 2006). The fact that nearly 20% of respondents wrote comments suggests that a number of patients want to express themselves beyond the response options on the HCAHPS survey, and their comments have value. Given the results of this study, several policy questions arise: on HcaHps s urveys researchers should apply systematic analytical tools to better understand how the comments relate to patient experiences. The more difficult question is whether to post comments (edited or unedited) in Hospital Compare, given (1) the expense and effort required to accomplish this task, (2) the difficulty of ensuring that individual institutions are not characterized unfairly, and (3) the need to guide consumers in using this information. However, given that such a small proportion of patients use the data currently displayed in Hospital Compare and considering the policy goal is to get consumers to use HCAHPS data to make informed decisions, this idea needs further study. Managerial implications The finding that patients' comments contribute to the prediction of global outcome measures should give administrators greater confidence to use anecdotal feedback and encourage them to take patients' negative comments seriously. This feedback can assist hospital staff in correcting problems and thus restoring consumer satisfaction and confidence in the provider (DeMatos, Henrique, & Rossi, 2007). However, hospitals do not receive timely information about a problem through written surveys such as HCAHPS because the information becomes available months after the patient has been discharged, so specific follow-up actions are all but impossible. From a hospital staff perspective, a particular negative patient experience is often not well remembered and circumstances are difficult to re-create, so the learning that could result in quality improvement is * Should space for comments be provided on HCAHPS surveys? * Should individual comments be shared online? * Should summaries be posted online? Further research should help inform the debate about these questions. This study suggests that the HCAHPS questionnaire should at least offer some space for patients' commentary, and 43

Table of Contents for the Digital Edition of Journal of Healthcare Management - January/February 2014

Journal of Healthcare Management - January/February 2014
Contents
Interview With Kenneth R. White, PhD, FACHE, Associate Dean for Strategic Partnerships and Innovation and the University of Virginia Medical Center Professor of Nursing, University of Virginia School of Nursing
Team-Based Care at Mayo Clinic: A Model for ACOs
The Management Springboard: Eight Ways to Launch Your Career as a Healthcare Leader
The Role of a Public–Private Partnership: Translating Science to Improve Cancer Care in the Community Donna M. O’Brien and Arnold D. Kaluzny
The Value of Patients’ Handwritten Comments on HCAHPS Surveys John W. Huppertz and Robert Smith
Can Inbound and Domestic Medical Tourism Improve Your Bottom Line? Identifying the Potential of a U.S. Tourism Market
Success Factors for Strategic Change Initiatives: A Qualitative Study of Healthcare Administrators’ Perspectives

Journal of Healthcare Management - January/February 2014