When it comes to improving your HCAHPS® scores, you may not know where to start.  Or maybe you are a hospital who scores very well in specific survey composites such as Responsiveness of Hospital Staff or Nurse Communications but you cannot figure out why your recent discharges rate your Doctor Communications so low.  Or perhaps you score above both the national average and state average for all composites but you fall below averages for the overall hospital rating score or likelihood to recommend.  These are all common problems that our hospital partners come to Research & Marketing Strategies (RMS) with and look to us for answers.  There are many different ways to tackle these issues you might be facing when improving your HCAHPS® scores. 

First of all, you are not alone.  Hospitals across the country grapple with the same HCAHPS® issues you face every day.  With CMS proceeding with its plan to introduce Hospital Value-Based Purchasing for IPPS hospitals, wherein HCAHPS® performance will account for 30% of Hospital VBP Total Performance Score in FY 2013, it’s in your best interest to dig deeper on the scores (in fact, if you Googled it and found us, you’ve already started!) 

So if you are thinking about how to improve your HCAHPS® scores, consider the following two RMS recommendations:

1) Conduct a series of hospital focus groups with recent discharges.

As an administrator, you might already think you know what your patients’ think of your hospital, but when you put them in a group setting using a third-party moderator with no affiliation to the hospital you might be surprised.  Your nurses might tell you that patients always appreciate and thank the nurses for showing up on time after the call button is hit, but results on the HCAHPS® survey show otherwise.  Through our past research with various clients we’ve learned that oftentimes patients are afraid that any feedback they offer while still in the hospital might impact their care.  Focus groups can explore the patient experience from admission through discharge and really explore problem areas throughout the inpatient process.

Focus groups are also a great stage to recreate the HCAHPS® experience.  In past focus groups, RMS has handed out an example copy of the instrument and explored reasons behind ratings such as “always,” “sometimes,” and numerical ratings such as “7” on the overall rating scale.  It provides the hospital team (who can view discussions live) with insight as to how/why patients are scoring the hospital.  Focus groups also allow the moderator a chance to explore what it would take them to score the hospital a 10.

Focus groups can be up and running fairly quickly.  RMS can handle the recruitment screener and calls to recent discharges (using our in-house call center), we can develop the draft moderator’s guide and participation packet with input from the hospital’s administrative team, we’ll be on-site to conduct your groups (managing all the logistics), and we’ll put together a PowerPoint report detailing findings, recommendations, and action items to improve your HCAHPS® scores.  RMS Healthcare works as a consultant with your hospital on top of just collecting the market research.

Unfamiliar with what a focus group is?  Click Here.

2) Use regression analysis and a priority matrix to quantitatively identify key drivers to hospital satisfaction.

If you’ve been participating in HCAHPS® for a while now, chances are you have built up a nice sample size of data with survey responses to all of the HCAHPS® questions.  If so, you may be able to answer the question of “how do we improve our HCAHPS scores?” in-house, if you have someone familiar with data analysis.  This will involve some advanced statistical analysis by reviewing correlation coefficients and regression measures.

Regression analysis basically takes all of your HCAHPS® questions (those never to always metrics; independent variables) and analyzes them to predict which of those questions most impacts overall satisfaction with your hospital (global 0-10 scale or likelihood to recommend; dependent variable).  Regression identifies which questions are the highest priority to focus on in order to have the most satisfied patients.  Therefore, regression can prioritize a series of HCAHPS® questions that are uniquely important to your hospital.  Theoretically, what you might learn is that ‘how well doctors explain things in a way you can understand’ has the largest impact on overall satisfaction.  So if you focus your efforts on driving up that one score, it will drive up your overall satisfaction.  RMS can work with you to set up a priority matrix (like the one you see below; taken from the CAHPS® AHRQ website).

Theoretical Example

Ultimately, there are number of different strategies you can pursue to improve your HCAHPS® scores – all of which offer different benefits to hospitals.  Through our knowledge of the CMS HCAHPS® survey and past experiences working with hospitals in a variety of settings, RMS recommends a combination of qualitative and quantitative research (as seen above) to lead you on the right path to improving your scores.  We are confident this two-pronged approach will provide you with the best answers and give you plenty of action items to improve your HCAHPS® scores.  And in CMS’ Hospital VBP scoring, any improvement in your HCAHPS® scores will increase your VBP Total Performance Score.

Are you a hospital interested in speaking with RMS Healthcare and how we can help you?  Contact our Business Development Director Sandy Baker  by calling her at 315-635-9802 or through email at SandyB@RMSresults.com.  Or if you have a quick question about HCAHPS®, just click on the ‘have a question’ contact box in the top right corner of this blog and the Bunker will send you a response.