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HCAHPS Survey Hospital Environment

Did you hear the news?

The Centers for Medicare and Medicaid Services (CMS) is planning to update its 13-year old HCAHPS patient experience survey.

Why did it take so long? Faced with declining response rates and and pressure from U.S. healthcare leaders who say the survey is out of step with how medicine is delivered today, CMS is doing what it should have done five years ago.

Because when government reimbursements to hospitals depend on survey results, the survey has to be good.

Adding Questions About the Hospital Environment

But what's the chance that any questions will be added to the Hospital Environment section of this multiple-choice survey?

Right now, there are only two:

  1. During this hospital stay, how often were your room and bathroom kept clean?
  2. During this hospital stay, how often was the area around your room quiet at night?

The reality is that the design of the built environment affects almost every aspect of the patient experience that the HCAHPS survey attempts to measure. But that may be a concept too complicated for CMS to understand or appreciate.

Built Environment Shapes the Patient Experience

However, CMS could acknowledge the importance of the built environment in shaping the overall patient experience by adding a few more questions to the Hospital Environment section. Here are a few suggestions:

  1. During this hospital stay, was there enough space for your loved ones to comfortably be with you?
  2. During this hospital stay, were there positive distractions that helped take your mind off your pain or condition?
  3. When you arrived at the hospital, was the waiting area comfortable and pleasant?

What questions would you suggest CMS add to the HCAHPS survey about the environment? Or how would you edit/rewrite these to be better?

Type them in the comment box below.

More Fun Facts About the HCAHPS Survey

  • CMS rolled out the HCAHPS Survey in October 2006; with the first public reporting in March 2008.
  • HCAHPS is administered by paper survey or telephone interviews to a random sample of adult inpatients between 48 hours and six weeks after discharge.
  • Up until a few years ago, the question about noise was the lowest scoring question on the HCAHPS survey. It is still the second lowest scoring question.
  • In 2013, three questions were added about the transition to post-hospital care, one about admission through the emergency room, and one about mental and emotional health.
  • In January 2018, the three questions about pain management were replaced by three questions about communication about pain; they were removed in 2019 over fears that they would lead to hospitals to overprescribe opioids to boost scores.
  • Official HCAHPS scores, based on four consecutive quarters of patient surveys, are publicly reported on the Hospital Compare website, four times a year.
  • In April 2015, CMS added HCAHPS Star Ratings to the Hospital Compare website, which summarize all survey responses for each HCAHPS measure.
  • In April 2019, CMS asked for approval from the White House Office of Management and Budget to collect public feedback from stakeholders on possible changes to the HCAHPS survey.
  • In August 2019, CMS announced that it plans to revamp its hospital ratings system in 2020.

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Leave a comment

Von Lambert

5 years ago

Here are a few for starters...

During your hospital stay;
Were you able to control the room temperature to a comfortable level
Were you able to control the lighting for reading/sleeping etc.
Did the staff appear well equipped, trained and prepared for your specific clinical and comfort needs
Were your alarms (if required) well managed and responded to in a timely manner
Was the room tidy and unused equipment/supplies/linen removed promptly
Were you able to effectively utilize the technology available? (i.e bed,. T.V., educational videos, food ordering, condition reporting, questions for providers etc.)
Were staff/visitor activities outside of your room disruptive

Sara Marberry

5 years ago

Those are great questions, Von!

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