Hello, I am a nursing student graduating in May, 2015. I have been a CNA for 8 years and work in the ICU until I graduate and find a RN position. I wanted to know what other nurses thoughts are regarding HCHAP scores/patient satisfaction. I sometimes have a hard time with them because a facility could literally save someones life but because they were perhaps a little late on bringing in that patients pain meds a facility could get a bad HCAHP score, causing the facility to lose out on payment. I know I don't completely understand all of the ins and outs of HCAHPS but I was just curious what other people thought about them.
I agree that a patient needs to be treated with respect, cared for in a timely manner, and have details about their care explained to them by not only nursing staff but also the physician, etc. I know it would take a lot of displeased patients to bring down a score sufficiently enough to prevent payment. However, a service was rendered, why shouldn't that service be paid for?
I'm just curious on others opinions about the matter. Perhaps this is an area that I need to familiarize myself more with as I step into the nursing role soon. Thanks for your input!
I absolutely believe with all of my heart that the things hospitals are rated for on CMS surveys SHOULD be assessed. Where I struggle is the requirement for answers to be "always". For instance, when you pushed your call bell, how often did you get care as soon as you needed it? I would bet you money 99% of people answer usually, if the unit is good at responding to call bells. Expecting "always" on some of these questions might be equivalent to expecting a unicorn for your birthday. Even with your best, fullest effort, giving people that "always" is often not possible.
If "usually" is a common response to that question in all hospitals then your hospital won't lose any reimbursement if your patients also answer "usually". Even if patients at your hospital frequently answer "never" to that question your hospital still won't lose money if that's how patients at most hospitals also answer the question.
HCAHPS isn't based on how well your hospital does on the survey, it's based on whether or not your hospital is significantly worse or significantly better than other hospitals, no matter how negatively patient might answer the questions overall.
Some of the responses to the surveys I've seen have offered very good feedback, some stated things that were beyond our control. Our case manager goes over the survey with the patient before they leave (most of our patients go to another facility when they leave us). We have had patients tell us everything was great and they loved it (answered top scores on all the questions up until the end). Then, when it comes to the overall rating (which is a 1-10 scale) and the willingness to recommend rating (which is a 1-4 scale), they give us a 7 and a 3 respectively. While these aren't horrible, they aren't what we aim for either (9-10, 4). When we ask if there was anything we could have done to receive a 9-10 and a 4, they tell us they wanted a private room and we didn't have any (which they new prior to agreeing to come to our facility). Stuff like that is painful to hear because we can't do anything about that (at our level). It would be a corporate decision to move us to a new location with private rooms (we rent our space from another facility). Those are the situations where reimbursement based on scores scare me.
MunoRN, RN
8,058 Posts
If "usually" is a common response to that question in all hospitals then your hospital won't lose any reimbursement if your patients also answer "usually". Even if patients at your hospital frequently answer "never" to that question your hospital still won't lose money if that's how patients at most hospitals also answer the question.
HCAHPS isn't based on how well your hospital does on the survey, it's based on whether or not your hospital is significantly worse or significantly better than other hospitals, no matter how negatively patient might answer the questions overall.