Agency for Healthcare Research and Quality Advancing Excellence in Health Care HCAHPS: Update for Trustees Mary Therriault RN MS Senior Director, Quality and Research Initiatives Healthcare Association of New York State July, 2012

Agency for Healthcare Research and Quality Advancing Excellence in Health Care HRET Curriculum: A New Way of Thinking about HCAHPS Hospital Consumer Assessment of Healthcare Providers and Systems

Advancing Excellence in Health Care What HCAHPS Means How Can you Always Help Patients/ Providers Succeed? 3

Advancing Excellence in Health Care 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

Advancing Excellence in Health Care 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 5

Advancing Excellence in Health Care Top four HCAHPS Priorities of over 430 hospitals participating in 18 HCAHPS PSLNs: 1. RN Communication 2. Responsiveness 3. Medication Communication* 4. Discharge Information* * HCAHPS domains addressed by a patient- centered discharge process HCAHPS and HEN Priority Challenges: Care Transitions and Adverse Drug Events 6

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

Advancing Excellence in Health Care  Provide expertise, research, and practical tools  Harness participants’ institutional wisdom  Build internal teams and external communities for ongoing improvement work Our Strategies 8

Advancing Excellence in Health Care In the United States, how many HCAHPS surveys: Will be administered today? Will be completed today? 9 Pop Quiz!

Advancing Excellence in Health Care 10 More than 25,000 surveys administered More than 7,500 surveys completed More than 7% of all hospitalized patients complete the survey HCAHPS Today Source: HCAHPS Executive Insight, October hcahpsonline.org. Centers for Medicare & Medicaid Services, Baltimore, MD.

Advancing Excellence in Health Care HCAHPS In a Nutshell  HCAHPS is a national standardized survey of hospital inpatients  27 questions  18 substantive questions  4 screening questions  5 demographic questions

Advancing Excellence in Health Care 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

Advancing Excellence in Health Care Patients See Things Differently Than Providers 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 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,

Advancing Excellence in Health Care The Evidence is Mounting HCAHPS Matters Clinically 14

Advancing Excellence in Health Care HCAHPS Strategies Implemented by 25 Hospitals in Learning Network 15

Agency for Healthcare Research and Quality Advancing Excellence in Health Care Why HCAHPS Matters: Value-Based Purchasing Implications

Advancing Excellence in Health Care 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 17

Advancing Excellence in Health Care How Are We Doing? 18

Advancing Excellence in Health Care New York Top Priorities for Improvement 19

Advancing Excellence in Health Care  Leadership Strategies  Strategies for Partnering with Patients and Families  Workforce Strategies  Data Use Strategies  Performance Improvement Strategies Essential Elements to Consider 20

Advancing Excellence in Health Care 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 Ideal Scenario 21

Advancing Excellence in Health Care  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 Improving Communication through Team Training AHRQ TeamSTEPPS 22