Hospital Consumer Assessment Of Healthcare Providers And Systems Survey Research Articles

Which Hospitals Promote a Sleep-Friendly Patient Experience?

The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey measures patient perceptions of hospital experience to determine the annual Center for Medicare and Medicaid Services (CMS) reimbursement. This study focuses on the "Quiet at Night" variable and identifies institutions with the highest scores to determine characteristics that facilitate patient sleep. The key findings were as follows: CMS Top Rated Hospitals have a mean score of 5 on the "Quiet at Night" variable.US News Honor Roll Hospitals have a mean score of 2.67, with a statistically significant difference of P < .001 between the groups.The key characteristics of the CMS Hospitals are that they are predominantly privately owned, specialized, surgical facilities with few total hospital beds.Knowing that HCAHPS scores directly impact and reflect patient experience, the objective of this study was to better understand the hospital practices that facilitate a high score on the "Quiet at Night" question to empower low scoring hospitals to improve their sleep practices at night and to score higher on the HCAHPS survey.

Correlation of Patient Reported Satisfaction With Adverse Events Following Elective Posterior Lumbar Fusion Surgery: A Single Institution Analysis

Structured BackgroundWith increasing emphasis on patient satisfaction metrics, such as the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, hospital reputations and reimbursements are being affected by their results. The purpose of the current study is to determine if post-operative self-reported patient satisfaction differed among patients who experienced any adverse event (AAE) following elective posterior lumbar fusion (PLF) surgery compared to those who did not.MethodsPatients who underwent elective PLF surgery performed at a single institution between February 2013 and May 2020 and returned an HCAHPS survey following discharge were included in the retrospective cohort analysis. Demographic, comorbidity, and HCAHPS survey data were compared between patients who did and did not experience any adverse event (AAE) in the 30-days postoperatively.ResultsOf 5,117 PLF patients, the HCAHPS survey was returned by 1,071 patients, of which 30-day AAE was experienced by 40 (3.73%). Of those that experienced AAE, the survey response rate was significantly lower (13.94% versus 21.35%, p=0.003). Those responding reported lower scores pertaining to if medication side-effects were adequately explained (22.22% versus 52.56%, p=0.002) and if post-discharge care was adequately explained (79.17% versus 93.76%, p=0.005), as well as overall top-box responses (67.62% versus 75.93% survey average, p<0.001).ConclusionsPatients experiencing AAE after elective PLF surgery are less likely to respond to surveys about their hospital experience. For those who did respond, they report less satisfaction with multiple aspects of their hospital care measured by the HCAHPS survey. Understanding how postoperative adverse events impact patients’ perception of healthcare quality provides insight into what patients value and has implications for optimizing their care.

Perception Meets Reality – Self-Reported Health on HCAHPS and Press Ganey Surveys Is Correlated with Validated Health Scores (ASA, CCI) in Orthopaedic Trauma Patients

Introduction The American Society of Anesthesiologists score (ASA) and Charlson Comorbidity Index (CCI) are validated tools to predict post-surgical outcome, cost, and health-related quality of life. Prior studies have had mixed results when comparing self-reported health from various survey instruments with ASA and CCI. Surveys such as the government-mandated Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) and optional private surveys (Press Ganey) administered following hospital discharge include self-reported health data. No prior study has examined the relationship between patient self-reported health from HCAHPS and Press Ganey surveys with validated health scores (ASA, CCI). We sought to study this possible relationship in orthopaedic trauma patients. Methods All consecutive adult patients &gt;18y surgically treated for isolated fractures at a Level 1 Trauma Center between January 1, 2014-December 31, 2016 were retrospectively analyzed. Hospital charts, HCAHPS, and Press Ganey data were reviewed; patients without available survey responses were excluded. Patient data also included comorbidities (ASA, CCI), psychiatric history (anxiety, depression, others), substance use, type of injury, and type of surgery. Statistical analysis included Spearman’s Rho for correlations, Wilcoxon Rank-Sum and Kruskal-Wallis for continuous variables, Backwards Stepwise Regression and Ordinal Regression with bootstrapped confidence intervals for odds assessment. Results 152 total patients with mean age 57 and median length of stay 3 days were included. No significant differences existed between injury, comorbidities, psychiatric history, substance use, or surgery. Median ASA was 2 (range 2-3), median CCI was 2 (range 0.5-4), and median CCI 10-year estimated survival was 90% (range 53-97). Median self-reported health rating was 1 (range 1-2, with 0 = excellent and 4 = poor). ASA and CCI both had initial strong correlations with patient self-reported overall health. Upon age and sex adjustment, only ASA remained strongly correlated (OR 3.65, 95% CI 2.03-6.57; p&lt;0.001) with overall health rating. Conclusion Orthopaedic trauma patients appear to have a realistic self-perception of health relative to validated scores. This is the first study to compare HCAHPS and Press Ganey self-reported patient health to ASA and CCI scores. Although further study is needed, the high agreement of self-perception of overall health with ASA scores may show that patient self-reporting is reliable in evaluating these and other outcome measurements.

The Impact of Dynamic Real-Time Feedback on Patient Satisfaction Scores.

Providers' communication skills have a significant impact on patients' satisfaction. Improved patients' satisfaction has been positively correlated with various healthcare and financial outcomes. Patients' satisfaction in the inpatient setting is measured using the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. In this study, we evaluated the impact of dynamic real-time feedback to the providers on the HCAHPS scores. This was a randomized study conducted at our 550-bed level-1 tertiary care center. Twenty-six out of 27 hospitalists staffing our 12 medicine teams (including teams containing advanced practice providers (APPs) and house-staff teams) were randomized into intervention and control groups. Our research assistant interviewed 1110 patients over a period of 7 months and asked them the three provider communication-specific questions from the HCAHPS survey. Our intervention was a daily computer-generated email which alerted providers to their performance on HCAHPS questions (proportions of "always" responses) along with the performance of their peers and Medicare benchmarks. The intervention and control groups were similar with regard to baseline HCAHPS scores and clinical experience. The proportion of "always" responses to the three questions related to provider communication was statistically significantly higher in the intervention group compared to the control group (86% vs 80.5%, p-value 0.00001). It was also noted that the HCAHPS scores were overall lower on the house-staff teams and higher on the teams with APPs. Real-time patients' feedback to inpatient providers with peer comparison via email has a positive impact on the provider-specific HCAHPS scores.

Hospital Consumer Assessment of Healthcare Providers and Systems survey response rates are significantly affected by patient characteristics and postoperative outcomes for patients undergoing primary total knee arthroplasty.

IntroductionThe Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey measures patients’ satisfaction of their hospital experience. A minority of discharged patients return the survey. Underlying bias among who ultimately returns the survey (non-response bias) after total knee arthroplasty (TKA) may affect results of the survey. Thus, the objective of the current study is to assess the relationship between patient characteristics and postoperative outcomes on HCAHPS survey nonresponse.MethodsAll adult patients at a single institution undergoing inpatient, elective, primary TKA between February 2013 and May 2020 were selected for analysis. Following discharge, all patients had been mailed the HCAHPS survey. The primary outcome analyzed in the current study is survey return. Patient characteristics, surgical variables, and 30-day postoperative outcomes were analyzed. Univariate and multivariate analyses were performed to identify factors independently associated with return of the HCAHPS survey.ResultsOf 4,804 TKA patients identified, 1,498 (31.22%) returned HCAHPS surveys. On multivariate regression analyses controlling for patient factors, patients who did not return the survey were more likely to have a higher American Society of Anesthesia score (ASA score of 4 or higher, OR = 2.37; P<0.001), and be partially or totally dependent (OR = 2.37; P = 0.037). Similarly, patients who did not return the survey were more likely to have had a readmission (OR = 1.94; P<0.001), be discharged to a place other than home (OR = 1.52; P<0.001), or stay in the hospital for longer than 3 days (OR = 1.43; P = 0.004).DiscussionFollowing TKA, HCAHPS survey response rate was only 31.22% and completion of the survey was associated with several demographic and postoperative variables. These findings suggest that HCAHPS survey results capture a non-representative fraction of the true TKA patient population. This bias is necessary to consider when using HCAHPS survey results as a metric for quality of healthcare and federal reimbursement rates.

The association between an established Chief Experience Officer role and hospital patient experience scores

The healthcare industry is currently reacting to multiple stakeholders demanding improvements to the patient experience. Some healthcare organizations are implementing new management structures, i.e., the role of Chief Experience Officer (CXO). This study statistically reviewed descriptors associated with hospitals that have and have not created and filled the role of CXO and, more importantly, measured the association between the CXO role and results of patients’ perceptions of their experience of care as measured by publicly reported Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) results. This study was conducted utilizing data gather on hospitals in three states, California, Florida, and New York. The results of the study yield insight into the organization characteristics of hospitals and the market factors associated with those hospitals that have filled the CXO role. Hospitals with a formal CXO role are larger, more likely to be for profit, and operate in metro areas of these states with higher per capita income. In addition, hospitals that have a formal CXO role are also more likely to have higher HCAHPS scores as determined by the patient recommendation question as well as the hospital overall rating question included in the HCAHPS survey.

Validation of a 5-Item Tool to Measure Patient Assessment of Clinician Compassion in Hospitals

BackgroundWe previously validated a 5-item compassion measure to assess patient experience of clinician compassion in the outpatient setting. However, currently, there is no validated and feasible method for health care systems to measure patient experience of clinician compassion in the inpatient setting across multiple hospitals.ObjectiveTo test if the 5-item compassion measure can validly and distinctly measure patient assessment of physician and nurse compassion in the inpatient setting.DesignCross-sectional study between July 1 and July 31, 2020, in a US health care network of 91 community hospitals across 16 states consisting of approximately 15,000 beds.PatientsAdult patients who had an inpatient hospital stay and completed the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey.MeasurementsWe adapted the original 5-item compassion measure to be specific for physicians, as well as for nurses. We disseminated both measures with the HCAHPS survey and used confirmatory factor analysis for validity testing. We tested reliability using Cronbach’s alpha, as well as convergent validity with patient assessment of physician and nursing communication and overall hospital rating questions from HCAHPS.ResultsWe analyzed 4756 patient responses. Confirmatory factor analysis found good fit for two distinct constructs (i.e., physician and nurse compassion). Both measures demonstrated good internal consistency (alpha > 0.90) and good convergent validity but reflected a construct (compassionate care) distinct from what is currently captured in HCAHPS.ConclusionWe validated two 5-item tools that can distinctly measure patient experience of physician and nurse compassion for use in the inpatient hospital setting in conjunction with HCAHPS.

Ethnicity and Language Differences in Patient Experience: an Analysis of the HCAHPS Survey.

Although there has been a rising emphasis on patient-centered care, limited research has assessed differences in patient experience based on ethnicity and language. This study examined differences in quality of care (N = 6945) using the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. Data were collected between January 2014 and April 2019. Bivariate and multivariate analyses assessed relationships between ethnicity/language with individual items capturing specific components of care and global hospital evaluations using regression modeling. Compared to English-speaking non-Hispanic White patients, Spanish-speaking Hispanic/Latinx patients reported more positive interactions with nurses, physicians, and the hospital environment and reported a better understanding of care after discharge. Findings also indicated that Spanish-speaking Hispanic/Latinx patients were more satisfied with their experience compared to non-Hispanic White patients. Spanish-speaking Hispanic/Latinx patients were more satisfied with specific components of care and also scored higher in a measure of the global patient experience. Findings suggest the need for setting clear expectations for health care encounters and adapting health system responses to better capture factors driving Hispanic/Latinx patient satisfaction.

Patient Satisfaction After Total Hip Arthroplasty Is Not Influenced by Reductions in Opioid Prescribing

BackgroundOpioids have played an important part in post-operative analgesia, but concerns with associated morbidity and the fate of leftover pills have prompted the creation of opioid-sparing protocols. The purpose of this study is to investigate the impact of the implementation of an opioid-sparing protocol on survey-based patient satisfaction scores following total hip arthroplasty (THA). MethodsThis study is a retrospective review of prospectively collected data on patients who underwent primary THA between November 2014 and July 2019. Inclusion criteria consisted of primary elective THA with complete Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey information. Cohorts were separated based on their date of surgery relative to the start of an institutional opioid-sparing-protocol in October 2018. Discharge prescriptions and refills were recorded on chart review and converted to milligram morphine equivalents (MME) for comparison between different opioids. HCAHPS results were analyzed for percentage of “top box” ratings for comparison between the 2 groups. ResultsIn total, 1003 patients met inclusion criteria: 804 pre-protocol and 199 post-protocol. Mean length of stay decreased from 1.74 ± 1.03 to 1.50 ± 1.11 days (P < .001). Pre-operative Visual Analog Scale pain decreased from 7.00 ± 2.30 to 6.41 ± 2.66 (P = .011) as did the rate of opioid refills (15.6%-9.1%; P = .019). Quantity of opioid medication prescribed upon discharge also decreased from 432 ± 298 to 114 ± 156 MME (P < .001). There was no change in “top box percentages” for satisfaction with pain control (79.7% pre-protocol, 82.1% post-protocol; P = .767). There was a significant increase in proportion of patients reporting top box satisfaction with their overall surgical experience after protocol implementation (88.2%-94.0%; P = .018). ConclusionA reduction in opioids prescribed after THA is not associated with a decrease in patient satisfaction with regard to pain control, as measured by the HCAHPS survey, nor is it associated with an increase in post-operative opioid refills. LOEIII. Clinical RelevanceThis study suggests that HCAHP scores are not negatively impacted by a reduction in post-operative opioid analgesics.

Evaluating the effects of a high-tech call system on patient-staff communication.

Evaluating the effects of a high-tech call system on patient-staff communication.

Patient Satisfaction After Lower Extremity Total Joint Arthroplasty: An Analysis of Medical Comorbidities and Patient Demographics

The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey has received increased attention to determine which demographics may influence patient satisfaction after Total Hip and Knee Arthroplasty. The purpose of this study was to evaluate the various effects that patient-specific factors, medical comorbidities, and demographics had on patient satisfaction. Two thousand and ninety-two patients underwent lower extremity total joint arthroplasty at our institution between 2014 and 2018. Nine hundred twenty-three of these patients responded to their HCAHPS survey (44%). Most patients (609, 66%) underwent primary total knee arthroplasty followed by 244 (26.4%) total hip arthroplasties, 35 (3.8%) revision total knee arthroplasties, 28 (3.0%) bilateral total knee arthroplasties, and 7 (0.8%) revision total hip arthroplasties. Increasing age and length of stay were associated with a decrease in patient satisfaction whereas patients who were married reported higher satisfaction. Patients discharged to a rehabilitation facility had a 12% decrease in top-box response rate compared to those discharged home. Contrary to our hypothesis, specific procedure type and the presence of comorbidities failed to predict patient satisfaction. The results of this study shed light on the intricate relationship between patient satisfaction and patient-specific factors. Furthermore, health care workers can counsel patients on expected satisfaction when considering total hip and knee arthroplasty.

Redesigning care coordination from the patient’s perspective.

6 Background: Cancer patients are frequently admitted to the hospital requiring medical oncologists to take an active role in coordinating with multiple teams. In an effort to redesign care to put patients at the center and address increasing demands on our medical oncologist’s time, we created the Oncology Coordinator (OC) role focused on care setting transitions. We aimed to evaluate whether the OC would improve quality of care and decrease healthcare utilization. Methods: The OCs, are non-clinical and serve as a single point of contact for disease-based teams as patients prepare for elective admissions or discharge from the hospital. The 3 OCs received specialized training in systems and processes in both settings. They coordinate outpatient appointments, prescription delivery, transportation while also providing clinical support. Additionally, they facilitate two interdisciplinary rounds per day across three dedicated oncology units and assist with patients off-unit. We evaluated all patient discharges facilitated by the OCs during 1/1/19-2/29/20 and compared that to non-OC facilitated discharges. Using descriptive statistics, we evaluated the OCs impact on 7- and 30-day readmissions, discharge before noon rate (DBN), average time from admission to chemotherapy start and patient experience as measured by Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). Results: We had a total of 2,818 discharges between 1/1/19-2/29/20; 1,032 (36.6%) facilitated by the OCs. For those OC facilitated discharges we observed a 5.07% reduction in 7-day readmissions and 30-day readmissions (2.6%). We observed an overall higher average monthly rate of DBN (4.85%) compared to non-OC facilitated discharges. In addition, the average time from admission to chemotherapy administration decreased by 1 hour 31 minutes (6.8%) for the OC facilitated admissions. In the HCAHPS survey, there were improvements in Discharge Information and Care Transitions on the inpatient units where OCs were most active. Conclusions: At our academic medical center, the OCs have contributed to reduction in readmissions, time from admission to chemotherapy administration as well as improvements in discharges before noon and patient experience. This pilot demonstrates that investment in dedicated lay staff to facilitate admissions and discharges for cancer patients across care settings could lead to meaningful improvements in healthcare utilization, quality and the patient experience. Future work will evaluate the sustainability of this program and evaluate association with healthcare costs.

Connecting Patients' Perceptions of Nurses' Daily Care Actions, Organizational Human Caring Culture, and Overall Hospital Rating in Hospital Consumer Assessment of Healthcare Providers and Systems Surveys.

The aim of this study was to connect patients' perceptions of nurses' daily care actions with patients' overall ratings of their hospital experience and hospitals' human caring culture. The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a national standardized survey measuring patients' hospital experience. Current literature lacks the connections between patients' perceptions of nurses' daily care actions and their overall hospital experience measured by the HCAHPS survey. This is a correlational study based on the HCAHPS surveys from patients discharged from a hospital in the United States. Correlations were conducted between patients' perceptions of nurses' daily care actions and overall hospital experience. A total of 3,258 (16.6%) patients returned the HCAHPS survey between January and May 2019. Significant relationships were found among patients' perceptions of nurses' daily care actions, hospitals' caring culture, and overall experience. Nurses' daily care actions significantly contribute to favorable patients' overall hospital ratings on HCAHPS.

The Association Between an Established Chief Experience Officer Role and Hospital Patient Experience

The healthcare industry is currently reacting to multiple stakeholders demanding improvements to the patient experience. Some healthcare organizations are implementing new management structures, i.e., the role of Chief Experience Officer (CXO). This study statistically reviewed descriptors associated with hospitals that have and have not created and filled the role of CXO and, more importantly, measured the association between the CXO role and results of patients’ perceptions of their experience of care as measured by publicly reported Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) results. This study was conducted utilizing primary research gather on hospitals in three states, California, Florida, and New York. The results of the study yield insight into the organization characteristics of hospitals and the market factors associated with those hospitals that have filled the CXO role. Hospitals with a formal CXO role are larger, more likely not to be not for profit, and operate in metro areas of these states with higher per capita income. In addition, hospitals that have a formal CXO role are also more likely to have higher HCAHPS scores as determined by the patient recommendation question as well as the hospital overall rating question included in the HCAHPS survey.

What Do Patients Want? A Qualitative Analysis of Patient, Provider, and Administrative Perceptions and Expectations About Patients' Hospital Stays.

Patient experience is increasingly recognized as a measure of health care quality and patient-centered care and is currently measured through the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). The HCAHPS survey may miss key factors important to patients, and in particular, to underserved patient populations. We performed a qualitative study utilizing semi-structured interviews with 45 hospitalized English- and Spanish-speaking patients and 6 focus groups with physicians, nurses, and administrators at a large, urban safety-net hospital. Four main themes were important to patients: (1) the hospital environment including cleanliness and how hospital policies and procedures impact patients’ perceived autonomy, (2) whole-person care, (3) communication with and between care teams and utilizing words that patients can understand, and (4) responsiveness and attentiveness to needs. We found that several key themes that were important to patients are not fully addressed in the HCAHPS survey and there is a disconnect between what patients and care teams believe patients want and what hospital policies drive in the care environment.

Using Laddering Interviews and Hierarchical Value Mapping to Gain Insights Into Improving Patient Experience in the Hospital: A Systematic Literature Review.

Hospitals are continuously facing pressures to mitigate the gap between patient’s expectations and the quality of services provided. Now with Medicare reimbursements tied to Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores, institutions are attempting interventions to increase satisfaction scores. However, a standard framework to understand patient values and perceptions and subsequently translate it into reliable measures of patient satisfaction does not exist, particularly in the inpatient settings. This article highlights opportunity for the addition of qualitative customer value research to augment the information providers gain from HCAHPS scores and provide additional indicators that can be used in improving the patient experience. In this article, patient laddering interviews and hierarchical value mapping are reviewed as methodologies to understand patient core satisfaction values during their hospital stay. A systematic literature search was performed to identify articles addressing laddering interviews and hierarchical value mapping as applied to health care. Inclusion criteria involved studies relating to health care and using laddering interviews. Exclusion criteria included non-health-care studies. Only 3 studies were found eligible for this review. Our systematic review of literature revealed only few studies which may help to guide us to improve patient experience using laddering interviews. These interviews can help compose a personalized bedside survey which may be more meaningful than current widely used HCAHPS survey.

The impact of Maryland all-payer model on patient satisfaction of care: A one-way analysis of variance (ANOVA)

ABSTRACT The purpose of this study was to assess if patient satisfaction, as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) significantly differ by year in the Maryland Global Payment implementation cycle. Data on inpatient ratings of hospital services was acquired from The Centers for Medicare and Medicaid Services (CMS). A non-experimental correlational design was used to examine the outcome and predictor variables during three points in time. A one-way analysis of variance (ANOVA) analyzed patient satisfaction scores of nine variables on the HCAHPS survey. The dataset included patient’s average satisfaction scores of hospitals by states. Maryland’s hospital data were extracted and manipulated with a pivot table from the HCAHPS original dataset for analysis. Communication about medicines was the only statistically significant difference observed during the study (F(2, 123) = 3.592, p = .030). The findings of this study can encourage healthcare providers and policymakers to place a high value on the creation and implementation of payment models to improve patient perception of care and, consequently, the quality of healthcare services.

Impact of Hospitalist Team Structure on Patient-Reported Satisfaction with Physician Performance.

Patient experience is valuable because it reflects how patients perceive the care they receive within the healthcare system and is associated with clinical outcomes. Also, as part of the Hospital Value-Based Purchasing (HVBP) program, the Center for Medicare and Medicaid Services (CMS) rewards hospitals with financial incentives for patient experience as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. It is unclear how the addition of residents and advanced practice clinicians (APCs) to hospitalist-led inpatient teams affects patient satisfaction as measured by the HCAHPS and Press Ganey survey. To compare patient satisfaction with hospitalists on resident, APC, and solo hospitalist teams measured by HCAHPS and Press Ganey physician performance domain survey results. Retrospective observational cohort study. All patients discharged from the Internal Medicine inpatient service between July 1, 2015, and July 1, 2018, who met HCAHPS survey eligibility criteria and completed a patient experience survey. HCAHPS and Press Ganey physician performance domain survey results. No differences were observed in the selection of "top box" scores on the HCAHPS physician performance domain between resident, APC, and solo hospitalist teams. Adjusted Press Ganey physician performance domain survey results demonstrated significant differences between solo hospitalist and resident teams, with solo hospitalists having higher scores in three areas: time physician spent with you (4.58 vs. 4.38, p = 0.050); physician kept you informed (4.63 vs. 4.43, p = 0.047); and physician skill (4.80 vs. 4.63, p = 0.027). Solo hospitalists were perceived to have higher physician skill in comparison with hospitalist-APC teams (4.80 vs. 4.69, p = 0.042). While Press Ganey survey results suggest that patients have greater satisfaction with physicians on solo hospitalist teams, these differences were not observed on the HCAHPS physician performance survey domain, suggesting physician team structure does not impact HVBP incentive payments by CMS.

The Association Between Physicians' Communication and Patient-Reported Outcomes in Spine Surgery.

Retrospective cohort study using prospectively collected data. Determine the association between satisfaction with physician communication and patient-reported outcomes in the inpatient spine surgery setting. Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys measure the patient experience of care and influence reimbursement for hospital systems and providers in the United States. It is not known whether patient satisfaction with physician communication is associated with better outcomes after spine surgery. Therefore, we evaluated the association between patient satisfaction with physician communication on the HCAHPS survey and improvements in validated patient-reported outcomes measures in a spine surgery population. HCAHPS responses were obtained for patients undergoing elective cervical or lumbar spine surgery from 2013 to 2015. Patient-reported health status measures were the primary outcomes, including EuroQol Five Dimensions (EQ-5D), Pain Disability Questionnaire (PDQ), and Visual Analog Scores for Back and Neck Pain (VAS-BP/NP). The association between satisfaction with communication and preoperative to 1 year postoperative changes in each health status measure was evaluated utilizing multivariable linear regression models. Our study included 648 patients, of which, 479 (74.4%) created our satisfied cohort. Demographically, our two cohorts were similar with regards to preoperative clinical measures; however, the satisfied cohort had a higher self-rating of their mental health (P < 0.01), and overall health (P < 0.01). After adjusting for clinically relevant confounders, our results demonstrated no significant association between satisfaction with physician communication and improvement in EQ-5D (P = 0.312), PDQ (P = 0.498), or VAS pain scores (P = 0.592). Patient satisfaction with physician communication was not associated with 1-year postoperative improvement in EQ-5D, PDQ, and VAS-Pain after spine surgery. These findings do not diminish the importance of effective communication between doctor and patient, but instead suggest that within the spine surgery setting, using only patient experience data may not accurately reflect the true quality of care received during their inpatient stay. 3.

Social media hospital ratings and HCAHPS survey scores

PurposeTo empirically verify whether patient hospital satisfaction ratings on social media such as Yelp provide similar information as the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys.Design/methodology/approachOLS and ordinal regressions performed on secondary data obtained from Yelp.com and 2016 Hospital Compare database disclosed by CMS.FindingsResults show that the patient hospital satisfaction ratings from Yelp can predict the patient experience of care domain scores obtained through the annual HCAHPS surveys and are also positively and significantly correlated to the overall hospital quality performance scores given by CMS.Research limitations/implicationsStudy suggests that social media patient review information could be used to supplement the information obtained from HCAHPS surveys, thereby providing hospitals more accurate information about their patient experiences.Practical implicationsHospital leaders need not wait an entire year to receive their HCHAPS scores to know about the issues related to their patient experience that need improvement and can periodically refer to free Yelp patient review scores on Yelp.com to obtain similar information.Originality/valueTo the best of knowledge, this research is the first to empirically demonstrate that patient reviews freely obtained from social media sites like Yelp can provide similar information as obtained from HCAHPS surveys and can thus be used to supplement HCAHPS.