Raising HCAHPS Scores. Annotated Bibliography - Essay Example

? Raising HCAHPS Scores Raising HCAHPS Scores Bower, K. A. (2009). Managing Care: The Crucial Nursing–Case Management Partnership. Nurse Leader 26-29. This article does not explicitly dwell on the improvement of HCAHPS scores in a hospital. However, the article introduces the concept of case management and its relationship with the cost benefits that an institution accrues once it implements effective and efficient case management in its operations. In this case, the author identifies the goals to effective case management as laying emphasis on clinical outcomes, satisfaction of patients, and compliance goals, which are elements that have a relationship with the importance of raising HCAHPS scores in an organization. Importantly, the author related the importance of effective case management with the financial incentives that an organization accrues. The author indicated that Medicare’s Recovery Audit Contractor program retracted more than $800 million from acute hospitals in three states during a demonstration project, although the program is now in practice in all the states. Hence, this implies that effective case management, which is associated with nursing and quality of care, is an important aspect of ensuring financial incentives in a hospital. On the other hand, improving effective case management improves the quality of care and has an effect on the improvement of HCAHPS scores in a hospital. Cliff, B. (2012). Excellence in Patient Satisfaction Within a Patient-Centered Culture. Journal of Healthcare Management 57(3): 157-159. Cliff provides the cost benefits of raising the HCAHPS scores in a hospital. In this case, she notes that the CMS’ value based purchasing (VBP) program in which payments, or reimbursements, are made based on patient satisfaction are related to HCAHPS scores. Hence, she highlights the important role played by raising these scores in order for hospitals to qualify for these incentives paid by the government. Her article focuses on the need to direct approaches of raising these scores towards patients as the center of attention in order to achieve high HCAHPS scores. Under the VBP program, Cliff indicates the existence of two domains that account for the full program. The first domain relates to the clinical process, which accounts for 70% of the performance score while the remaining percentage is the patient experience domain, which is the basis for the HCAHPS score. In line with this, Cliff highlights the cost benefits aspect of including these measures in provision of incentives to a hospital that provided quality care. Cliff not only highlights the importance of improving the quality of care by raising HCAHPS scores in a hospital, but also discusses the existence of financial rewards associated with the raising of these scores. Elliot, M. N., Lehrman, W. G., Goldstein, E., Hambarsoomian, K., Beckett, M. K., & Giodano, L. A. (2009). Do Hospitals Rank Differently on HCAHPS for Different Patient Subgroups? Medical Care Research and Review 67(1): 56-73. The authors take a patient-centered approach towards establishing HCAHPS measures while precisely focusing on the aspect of patients’ experiences in a hospital setting. The authors describe the reliability of patient-reported measures within the hospital levels, which is through investigating the extent of observable differences within a hospital setting and their representation as true differences in experiences. Using patients’ experiences in nine measures, the researchers used the experiences of 1,203,229 patients discharged from hospitals around the country between 2006 and 2007 with these patients being a blend of patients who visited acute and critical access hospitals. Importantly, the researchers found out that raising HCAHPS scores in the hospital setting is crucial in measuring the distinction of the quality of care in a hospital and this distinction contributes to high reliability in a hospital setting. In effect, these researchers bring out the theory of high reliability in service design and link this concept to raising HCAHPS scores in an organization. The researchers identify aspects that contribute to the ranking of a hospital by indicating that elements such as the age of patients, health status, their race, ethnicity, and their level of education had an effect on the varying substantial ranking among hospitals. However, it would have been appropriate for the researchers to highlight the different ways that these aspects influence HCAHPS scores. Giordano, L. A., Elliot, M. N., Goldstein, E., Lehrman, W. G., & Spencer, P. A. (2010). Development, Implementation, and Public Reporting of the HCAHPS Survey. Medical Care Research and Review 67(1): 27-37. The researchers provide a comprehensive overview that highlights the stages that lead to the development, implementation on a national level, and public reports of HCAHPS survey reports nationally. The work by these researchers is crucial since it provides a historical perspective that led to the development of the HCAHPS scores measure and the players that contributed to its development. In addition, they highlight the challenges that were faced during the implementation of the HCAHPS survey and the approaches used to deal with these challenges. In line with its comprehensive nature, the research provides a detailed expose on the instruments and protocols used in the HCAHPS survey. Unlike other researchers whose work I am going to use, these researchers do not only highlight that the survey contains 27 items, but they also breakdown the items into two subparts with each subpart highlighting a different phenomenon. On the other hand, the survey provides conditions that make a patient eligible to participate in a HCAHPS survey. In line with this, they also provide conditions and procedures that qualify a hospital’s participation. I find the work by these researchers enlightening since they also provide the approach for public reporting, which will be essential in the development of an action aid plan aimed at raising HCAHPS scores in a hospital. Goldstein, E., Elliot, M. N., Lehrman, W. G., Hambarsoomian, K., & Giordano, L. A. (2010). Racial/Ethnic Differences in Patients' Perceptions of Inpatient Care Using the HCAHPS Survey. Medical Care Research and Review 67(1): 74-92. In one of their previous studies, these researchers had identified the aspects of race, or ethnicity, as one that played a fundamental role in influencing the perception of the patients and their overall response in the HCAHPS survey. The researchers therefore use this study as a follow-up study to investigate the various ways that race, or ethnicity, influenced these scores. This study is crucial in the designing of an action plan that implements the approaches an organization will use to raise its HCAHPS scores. In this regard, the approach taken by the research to use data from over 2,648 hospitals and compare the experiences of various patients, from diverse ethnic backgrounds, is essential in developing an action aid plan for an organization that served diverse people. Using comparative analysis, the researchers investigated the experiences that led to the understanding of inpatients’ roles and perspectives of care and any perceived differences within the hospital setting between African-Americans, Hispanics, and other minorities on one hand, and non-Hispanic Whites on the other hand. Fundamentally, the study observed that non-Hispanic White communities sought care from hospitals that provided all patients with better experiences than those hospitals used by the minorities. In effect, the research conclusively provides aspects that healthcare providers need to target in order to reduce the existing disparities in patients’ experience. Hence, the study provides an effective approach that will be incorporated in the action aid plan with an objective of providing equal patients’ experience to all patients who visited the facility. Hanna, M. N., Fernandez, M. G., Barrett, A. D., Williams, K. A., & Pronovost, P. (2012). Does Patient Perception of Pain Control Affect Patient Satisfaction Across Surgical Units in a Tertiary Teaching Hospital? American Journal of Medicine Quality 27(5): 411-416. In a similar way to a research study conducted by Martin, Kelly, and Roosa (2012), the researchers in this study focused on the aspect of pain management. However, their focus was in surgical units located in a tertiary teaching hospital, unlike the study by the other researchers who participated in the process that led to effective pain management in their facility. Nonetheless, these two research studies identify the importance of improving pain management cultures as instrumental in increasing the satisfaction of patients. Consequently, it is evident that improving customer satisfaction was an efficient approach that hospitals can use to improve HCAHPS scores. The researchers investigated the connection between the perception of patients in the methods of pain control during the process of care giving and treatment, and their satisfaction with the quality of care they received. In order to achieve this, the researchers focused on 4,349 adult patients. Incidentally, the results indicated that the perception that nurses and caregivers did everything to control their patients’ pain, despite the pain not being well controlled contributed to high satisfaction among patients. Huppertz, J. W., & Carlson, J. P. Consumers’ Use of HCAHPS Ratings and Word-of-Mouth in Hospital Choice. Health Research and Educational Trust 1602-1613. DOI: 10.1111/j.1475-6773.2010.01153.x These researchers focused on the impact of the HCAHPS scores and ratings in a hospital, based on patients’ experiences, and the word-of-mouth narratives that consumers spread to other consumers on the choice of hospital. The study was conducted online with a panel consisting U.S. adults over the age of 18 years. It involved a random assignment of 309 consumers to observe the negative and positive information about a hospital under two modalities of HCAHPS scores and a narrative that was in form of email sent to the respondents. The key findings indicated similar impacts on the choice of hospital that consumers choose based on a simple paragraph in the email and 10 HCAHPS graphs. In addition, the researchers found out that inconsistent information between the two modalities contributed to one modality attenuating the other modality’s effect on the choice of hospital in a customer. In effect, these findings are crucial in ensuring that a designed action aid plan aiming at raising HCAHPS scores was not affected by word of mouth communication among patients. Jennings, N. (2010). Defining a Caring Hospital by Using Currently Implemented Survey Tools. Journal of Holistic Nursing 28(3): 187-192. Jennings identifies the importance that hospitals have attached on providing quality care to patients, which was also cost-effective. However, the author highlights the challenge that organizations faced in striking a balance between the demands that regulatory bodies required of a hospital and the approaches towards meeting all the needs of patients in a hospital. Moreover, the author noted the challenge that hospitals faced in determining whether an organization was providing an exceptional environment for care, which is a result of collecting separate data that is an added burden. However, the author provided an effective way of solving this challenge by the use of survey tools that are already in use in hospitals. One such tool is the HCAHPS survey, which the author notes as a mandatory tool to use since its implementation provides the hospital with a chance of receiving full payment. Other than highlighting the financial benefits of implementing the HCAHPS tool, the author notes that most tools focused on the patient in the provision of holistic care. The author identifies being present for the patients in order to respond to their needs, supporting the belief system of the patients, establishing a trusting relationship between patients and nurses, and assisting the patients in meeting their spiritual and physical needs as appropriate approaches towards raising HCAHPS scores. Long, L. (2012). Impressing Patients While Improving HCAHPS Scores. Nursing Management Journal, 32-37. Like Rutledge, Long’s work discusses the 27-item survey given to patients after discharge. In this case, Long provides similar aspects to Rutledge on the focus of HCAHPS surveys while highlighting that these surveys’ focus on the perceptions of the patients. In addition, the author provides the incentives that a healthcare facility gains with regard to their HCAHPS scores. In line with this, the article will be crucial in identifying the cost benefits of raising the HCAHPS scores in a hospital setting. The author highlighted the percentage of funding that organizations received based on their HCAHPS scores. Long provides fundamental approaches that an organization can use to raise its HCAHPS scores. Among the proposed approaches, she observed that a lower patient-to-nurses ratio coupled with high proportions of Registered Nurses in a healthcare facility as fundamental in raising HCAHPS scores. In addition, the author indicates the presence of a close relationship between patients’ satisfaction and various factors in nursing. Moreover, the author posits that the ratings that nurses gave their work environment had a close relationship with patient satisfaction measures in HCAHPS scores. Long identifies the need of hospitals to focus on interpersonal aspects of care in order to raise their HCAHPS scores. In effect, the interpersonal aspect that she highlights involves the organizational culture that focuses on the patients and provision of services to patients in all levels. Unlike Rutledge, Long explains the eight-items as comprising the patients’ experiences field. Overall, this work will be crucial in developing the cost-benefits in improving the action aid plan for raising HCAHPS scores and emphasizing approaches to improving these scores. Martin, L., Kelly, M. J., & Roosa, K. (2012). Multidisciplinary Approach to Improving Pain Management. Critical Care Nursing Quarterly 35(3): 268-271. This article highlights an approach that was successfully used to raise the HCAHPS scores from a lowly first percentile to a highly impressive 90th percentile score in a period of five months. However, the article focused on only one aspect of the hospital’s patient dissatisfaction with the approaches that the hospital used to manage pain. In this regard, the HCAHPS scores in managing pain were low, which contributed to the decision to develop an approach that aimed at raising these scores. The authors indicate that the hospital carried out a review of the HCAHPS scores and brainstormed on the possible factors that lead to the low HCAHPS scores. This approach is crucial in developing an action aid plan for developing procedures aimed at improving the HCAHPS scores in a hospital. Like many other research articles on raising HCAHPS scores, this article identified the role of communication in developing the tools and approaches to improve the HCAHPS scores in a hospital. Rutledge, N. (2008). The 411 on HCAHPS. Nursing Management Journal 29-32. In order to raise HCAHPS scores, Rutledge recognizes the importance of communication in achieving high scores. In line with this, a developed survey that investigates the approaches of raising HCAHPS scores focuses on seven aspects that have a communication link. First, the survey focused on the aspect of communication with physicians. The other aspects were communication with nurses in a healthcare facility that wants to raise HCAHPS scores. Other aspects are the aspects of the hospital staff’s responsiveness, the quietness of the environment of a hospital and its cleanliness, patients’ discharge information, approaches of managing pain among patients, and communication of medication to patients and their family. Importantly, this survey is crucial to the study that I am undertaking in the approaches to raise HCAHPS scores since it highlights the goals of HCAHPS scores and highlights the previous challenges faced in comparing data and measuring data between hospitals since the methods of collecting data were not standardized. Using various instruments of research, the survey developed a 27-item instrument organized into 22 questions divided in various subheadings. Finally, Rutledge investigated factors that contribute to improvement of HCAHPS scores, which will help my research topic since it is the central theme of my work. While most of her work focused on a survey to investigate approaches to raising scores, her work in providing approaches of raising scores and the aspects to focus on while raising scores is crucial for my research work. Shaffer, F. A., & Tuttas, C. (2008). HCAHPS: Nursing Moment’s in the Sun. Nurse Leader 48- 51. Shaffer and Tuttas’ research was on the onset of HCAHPS introduction to the American healthcare sector. In effect, the researchers indicated that a hospital’s scores had a connection with the quality of care that nurses provided and the consequent reimbursement that the healthcare facility received. Incidentally, the researchers pointed out that despite various approaches that focus on improvement of the quality of care, the quality of care did not have any relationship with the financial rewards a hospital accrued. The researchers provide the goals of the HCAHPS survey while highlighting the areas that a healthcare facility should emphasize on to raise its HCAHPS scores. Like most of the research articles I will rely on for my research work, this article highlights the contents of HCAHPS although not in a comprehensive approach. The study provides a synopsis for the survey results released in 2008. In line with highlighting the need for raising HCAHPS scores in hospital, the researchers indicate that the government stopped reimbursing hospitals for conditions related to hospitals’ treatment of pneumonia, heart, and other conditions and instead focused reimbursement on the improvement of HCAHPS scores in 2008. The focus of this research study was on the implications of raising the HCAHPS scores in terms of reimbursement. In this case, the study provides the cost-benefits of raising these scores and provides a systematic approach that nursing leaders must take to raise HCAHPS scores in order to benefit from reimbursements. Shaffer, F. A., & Tuttas, C. (2010). Completing the Circle: The Embodiment of Quality Across the Care Delivery Continuum. Nurse Leader 35-39. doi:10.1016/j.mnl/2010.07.005 In this article, Shaffer and Tuttas do not investigate approaches to improve HCAHPs scores in an organization. However, the two authors highlight the importance of hospitals to ensure that their contracted staff met the quality standards that that were equivalent to hospital staff in the facility. In achieving this, the authors highlight the important role played by collaboration among different healthcare facilities. In this case, they highlight the importance of credentialing and assessment of competencies among the hospital staff that was retained in the hospital under healthcare staffing service (HCSS) firms whose certification is by The Joint Commission (TJC). It is evident that authors did not focus on the issue of raising HCAHPS scores in their work. However, the authors highlighted the importance of ensuring that members of staff in a hospital met all the standard requirements in order to ensure that the facility provided quality care to its patients. Hence, the provision of quality care to patients ensured that the patients were satisfied with the services that a hospital offered, which leads to the improvement of HCAHPS scores. In effect, this article highlights the importance of ensuring that the qualifications, credentials, and the certification of the nurses was efficient in a manner that promoted provision of quality care before implementing the action aid plan that aims at raising the HCAHPS scores in a hospital. Windish, D. M., & Olson, D. P. (2011). Association of Patient Recognition of Inpatient Physicians with Knowledge and Satisfaction. Journal for Healthcare Quality 33(3): 44-49. The study focused on patients’ recognition of their healthcare providers and linked this aspect to patient knowledge and satisfaction of care. This study is crucial for my research work since it focuses on one aspect that may affect HCAHPS scores, which is the aspect of customer satisfaction. In line with this, the study recognizes that patient satisfaction with care remained low when patients failed to recognize the hospital by name, face, and the role they played during the process of care. Hence, the study emphasizes the importance of ensuring patients recognized the facility by name, face, and they participated in the provision of care. Zusman, E. E. (2012). HCAHPS Replaces Press Ganey Survey as Quality Measure for Patient Hospital Experience. Neurosurgery 71(2): 21-24. Zusman publishes a summary of the HCAHPS survey that is mailed to patients to measure their satisfaction level with quality of care. This aspect of publishing the 27-items is crucial in the development of an action plan for a hospital. In this regard, the 27 items published by Zusman will help recognize the aspects that require improving in order for the facility to raise its HCAHPS scores. The summary is divided into seven sections with each section providing a different aspect that the hospital should address in order to improve HCAHPS scores. Zusman noted that the HCAHPS survey replaced the Press Ganey score in measuring the quality of patients’ experience in hospitals. In line with this, Zusman observed that the identification of the weaknesses and flaws in the Press Ganey score in measuring patients’ satisfaction and reporting would help physicians become informed users of the HCAHPS survey. The article also identifies the cost benefits of raising the HCAHPS scores in a hospital, like similar articles identified, but goes further to identify the existence of biases based on the various tools that hospitals use to measure quality and patients’ satisfaction. Nonetheless, the study points the need for harmonizing the measure of satisfaction, which is primarily by the HCAHPS survey. Read More