Alabama Hospitals Part of Nationwide Survey that will Help Consumers Compare Hospitals

Alabama's acute care hospitals are gearing up to participate in a nationwide survey sponsored by the Agency for Healthcare Research and Quality and the Centers for Medicare & Medicaid Services (CMS). The survey, called the Hospital CAHPS (HCAHPS), is to become a standardized survey instrument designed to help consumers make "apples to apples comparisons between hospitals," says Keith Granger, chairperson of the Alabama Hospital Association's Quality Task Force. "Up to the development of HCAHPS, there had been no national standardized questionnaire available for hospitals to use to survey patient satisfaction," says Jeff Morgan, founder of JL Morgan and Associates Inc., a Birmingham healthcare survey research firm. "That's why CMS and the Agency for Healthcare Research and Quality (AHRQ) cooperated to devise and scientifically test the survey instrument." The pilot or "mode" portion of the survey involved interviewing patients who had been discharged between the months of February and April from at least one hospital in every state. The only Alabama hospital to participate in the pilot was Dothan's 235-bed Flowers Hospital, a full-care tertiary facility serving the southeast portion of the state. "This is an important undertaking because it is the first attempt to create a standardized survey instrument that can be used nationwide so consumers can compare hospitals side-by-side on various patient satisfaction measures," says Granger, CEO of Flowers Hospital. "Our goal was to help develop data that would help every Alabama hospital improve patient services." The second part of testing the survey instrument occurred during the months of April to June when hospitals throughout the United States conducted a "dry run" data collection effort to eliminate any kinks in the interview gathering and analysis system. Morgan's firm was one of only 47 in the nation authorized to contract with hospitals to conduct the 27-question survey during the initial and "dry run" stages of the project. "The survey has been designed to find out things like how quickly a nurse responds to a patient's use of a call button for assistance, how effective physicians are in pain management and other matters of importance to patients," Morgan says. Hospital patients of all payer types are eligible for sampling, with participants selected at random. CMS methodology requires that survey patients be contacted 48 hours to six weeks post discharge. Among the topics covered in the survey are physician and nurse communication, cleanliness and noise levels of the hospital environment, responsiveness of the hospital staff to patients' questions, pain management and communication regarding medications and discharge information. The live program begins in October 2006. The initial public reporting period will cover discharged patients within the three quarters of October - December 2006, January - March 2007, and April - June 2007. Subsequent public reporting periods will cover 12 months and be updated quarterly with results posted on the United States Department of Health and Human Services (HHS) Hospital Compare Web site. Data from the pilot and "dry run" efforts will not be reported. CMS has requested that hospitals survey at least 300 patients during the initial nine month reporting period. A hospital's data results will only be publicly reported if there are a minimum of 100 surveys completed, which could affect small, rural hospitals that lack the patient volume. "When compiled and posted, the data will give the public the ability to see - prior to making a decision as to where to go to get hospital care - how other patients rated their own experiences at various hospitals," Granger says. "If a potential consumer sees that a hospital is getting low ratings for responsiveness or low ratings for cleanliness, or pain management, or any of several other criteria, then the consumer may decide to choose to go to a hospital with a higher rating." "The bottom line is that the HCAHPS survey instrument will give consumers the ability to compare, judge and decide where they want to go for medical care," Morgan says. Likewise, healthcare providers will be interested in finding out what consumers actually think about the care they have received. "You can be sure," Morgan says, "that hospitals will use the HCAHPS data to make improvements in systems to provide better care in any deficient areas."