Comparing Patient Satisfaction Scores to Measure Improvement

Patients’ satisfaction with care is an important health care metric as the hospital community continues to move towards value-based and consumer-driven delivery models. Positive patient experiences impact hospitals in several ways. Satisfied patients are more likely to participate in their care. This can enhance a hospital’s reputation. There is also evidence that positive patient experience, such as good communication between clinicians and patients, can improve clinical processes and outcomes.1 As health care providers gain greater insight about the link between patient experience and hospitals’ operational performance and clinical outcomes, efforts to improve satisfaction scores are taking on greater prominence. The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is the leading measure of patient experience. HCAHPS relies on a standardized survey developed by the Centers for Medicare & Medicaid Services (CMS) to evaluate patient perceptions about care. The survey asks patients to rate their experience across 11 dimensions of care. Survey results are published online on the Hospital Compare website. For this Research Corner column, the VHHA Analytics Team conducted a comparison of Virginia’s current performance to baseline levels relying on publicly reported Hospital Compare data to determine whether there is a relationship between improved scores and national rankings. The goal of this analysis is to assess Virginia’s performance alongside other states. Calendar year 2014 is the baseline for this exercise. The most recent performance period (April 2016-March 2017) is the comparison range. Data is based on average publicly reported “top box” scores for participating hospitals in the state. The “top box” score for each measure is the percentage of a hospital’s patients who chose the most positive, or “top box” response, for each domain. Virginia experienced improved scores in 45 percent (five of 11 HCAHPS domains) when compared to 2014 performance. While this is an indication of overall improvement in patient experience, it is important to note that hospitals in other states also prioritize improvement, meaning commitment to patient experience improvement isn’t unique to Virginia. Hospitals in the Commonwealth are effectively competing against hospitals in other states also working to improve patient experience scores. Of the five domain areas in which Virginia recorded improvement, gains in just three of those categories resulted in an improved national ranking. Overall, Virginia improved its national ranking 36 percent (in four of 11 HCAHPS domains) between the two time periods. (4/13)