HRET Curriculum: A New Way of Thinking about HCAHPS

1. HCAHPS: Update for TrusteesMary Therriault RN MSSenior Director, Quality and Research Initiatives Healthcare Association of New York State July, 2012

2. HRET Curriculum: A New Way of Thinking about HCAHPS Hospital Consumer Assessment of Healthcare Providers and Systems

3. What HCAHPS Means How Can you Always Help Patients/ Providers Succeed?

4. AHRQ/HRET Patient Safety Learning Network (PSLN) Project • HANYS, HRET and AHRQ are partners in bringing you this free program of technical assistance for 6 months. • AHRQ has retained HRET to partner with health care leaders in creating Patient Safety Learning Networks to support hospitals that wish to use AHRQ’s patient safety improvement tools. • HRET will support learning network members in using HCAHPS, as well other AHRQ patient safety tools in 25 States during 2012.

5. Acknowledgements • This program is supported by the U.S. Agency for Healthcare Research and Quality (AHRQ) through a contract with the Health Research and Educational Trust (HRET). • HRET is a charitable and educational organization affiliated with the American Hospital Association, whose mission is to transform health care through research and education. • AHRQ is a federal agency whose mission is to improve the quality, safety, efficiency, and effectiveness of health care for all Americans. • Faculty: Carrie Brady, MA, JD • Primary HCAHPS trainer • Former Connecticut Hospital Association staffer • Previous V.P. at Planetree

6. HCAHPS and HEN Priority Challenges: Care Transitions and Adverse Drug Events Top four HCAHPS Priorities of over 430 hospitals participating in 18 HCAHPS PSLNs: • RN Communication • Responsiveness • Medication Communication* • Discharge Information* * HCAHPS domains addressed by a patient-centered discharge process

7. Our Goal To support hospital teams in effectively using HCAHPS as a tool for improving quality, safety, and the patient experience.

8. Our Strategies • Provide expertise, research, and practical tools • Harness participants’ institutional wisdom • Build internal teams and external communities for ongoing improvement work

9. Pop Quiz! In the United States, how many HCAHPS surveys: Will be administered today? Will be completed today?

10. HCAHPS Today More than 25,000 surveys administered More than 7,500 surveys completed More than 7% of all hospitalized patients complete the survey Source: HCAHPS Executive Insight, October 2011. hcahpsonline.org. Centers for Medicare & Medicaid Services, Baltimore, MD. http://www.hcahpsonline.org/Executive_Insight/.

11. HCAHPS In a Nutshell • HCAHPS is a national standardized survey of hospital inpatients • 27 questions • 18 substantive questions • 4 screening questions • 5 demographic questions

12. HCAHPS Topics • CMS reports individual scores for: • Cleanliness • Quiet at night • Overall rating • Willingness to recommend • CMS reports composite scores for 6 topics: • Nurse Communication • Doctor Communication • Medication Communication • Responsiveness • Pain Management • Discharge Information

13. Patients See Things Differently Than Providers Source: Weingart SN et al. “Patient-Reported Safety and Quality of Care in Outpatient Oncology” Joint Commission Journal on Quality and Patient Safety; 33:2, 2007 22% of 193 patients reported a “recent unsafe episode” More than 80% of the reported experiences were classified by reviewers as “service quality incidents” • 33% related to waits and delays • 21% related to poor communication and information for patients • 13% related to poor coordination of care among staff

14. The Evidence is Mounting HCAHPS Matters Clinically

15. HCAHPS Strategies Implemented by 25 Hospitals in Learning Network

16. Why HCAHPS Matters: Value-Based Purchasing Implications

17. VBP Overview • DRG payments initially reduced by 1% in FY2013 • reduction rises by 0.25% each year, ending with 2% reduction in FY2017 • Payments adjusted based on performance on HCAHPS (30%) and clinical process measures (70%) • Hospitals may earn VBP points in two ways: • By achieving a certain level of performance or • By improving their performance • More points available for achievement than improvement

18. How Are We Doing?

19. New York Top Priorities for Improvement

20. Essential Elements to Consider • Leadership Strategies • Strategies for Partnering with Patients and Families • Workforce Strategies • Data Use Strategies • Performance Improvement Strategies

21. Ideal Scenario HCAHPS is viewed as a valuable tool to help organizations achieve multiple objectives HCAHPS is part of a coordinated, comprehensive approach to partnering with patients and families Everyone works together as a team to identify opportunities for improvement, innovate and implement strategies, and celebrate success

22. Improving Communication through Team Training AHRQ TeamSTEPPS • A comprehensive evidence-based system to enhance teamwork and communication among healthcare professionals • HRET is the national training contractor • Free curriculum and tools available at http://teamstepps.ahrq.gov/index.htm