HCAHPS

HCAHPS / en Tue, 22 Oct 2024 23:26:49 -0500 Sun, 23 Mar 14 14:43:50 -0500 Strong, Vibrant and Visible /strong-vibrant-and-visible <h4>By Michael Bailey, CHESP</h4> March 23, 2014&nbsp;|&nbsp;Formats:&nbsp;Article&nbsp;|&nbsp;Content Areas:&nbsp;Administration&nbsp;|&nbsp;Tags:&nbsp;Communication, Finance &amp; Budgeting, HCAHPS, Leadership, Management <hr /> Welcome to 2014 and what will certainly be another year of big change in health care. The implications and ramifications of the Affordable Care Act will become ever more apparent as we move forward. There are plenty of questions surrounding this new program but, at this point, not many answers. One thing is for sure: business as usual will not be an option if health care institutions are to continue to grow and thrive. Shrinking reimbursements and increasing regulations will force all of us to seriously review our operations and strategy. In other words, we need to be strong, vibrant and visible leaders in our institutions. A recent survey of hospital CEOs listed financial concerns as the main issue on the table in 2014. Reduced Medicare and Medicaid payments, anticipated decreases in volumes, increasing acuity levels, and increasing equipment and supply expenses are all adding to a situation that will take knowledge and leadership to address. We are dedicating this edition of EXPLORE to the discussion of how these issues will affect environmental services across all care settings. Let’s take a look at a couple of the most pressing problems confronting our profession in the immediate and the near future. Measureable and defensible evidence If CEOs are worried about finances, then it would be prudent for us to more than consider them and how we can contribute to ease some of the pressure on the executive teams and the&nbsp;boards of directors. Most of us are accustomed to staffing cuts at this point. A manager swallows the pill and does what has to be done to meet the targets. However, a leader understands the importance of being at the table armed with not only passion for what we do but more importantly, armed with the data we need to substantiate the investment being made in our services. Do you have the data, information and leadership skills to represent yourself and your department at the table? Simple answers and explanations will not serve us going forward. We need measureable and defensible evidence, metrics and data to illustrate the impact and value of our services to our customers. We need to be worthy of the respect we desire. Do you know who has this information or how to create your own? Impact of HCAHPS scores Because a portion of reimbursements are tied to satisfaction, we cannot forget about the impact of HCAHPS scores on our institutions. With dwindling resources and increasing expectations, we need to think innovatively when looking at staff productivity and ask ourselves whether we are getting the return from our labor dollars. Have we developed a hiring protocol for the department that addresses not only experience but behaviors? Are we conducting behavior-based interviewing and hiring for customer-focused skill sets to ensure we have the service-minded personalities on the front line? Do we teach strategic skill-building? Can staff make ethical choices? Are we hiring the first person through the door hoping we can on-board them with a fast wave of technical training? Are we hiring coachable, teachable staff that will assimilate into the culture of service? Are we coaching and nurturing the next wave of supervisors and managers so we can lead, not just work? As leaders, we need to develop criteria and expectations for our hiring and orientation programs to ensure we are getting the best and brightest. Great attitudes and high performance will be the key to our success with customer service. Increasing territories and responsibilities In addition to finance and customer service issues, we also need to be focused on the increasing territories&nbsp;and responsibilities being added to our plates. Most of us are dealing with more than one facility, and many of us are being asked to take on other departments. According to the trending experts, health care is and will continue to be delivered away from the acute-care hospital setting. What types of issues does this present to us as patients are seen farther away from our concentration of resources? What is your vision for the care and services that are provided away from the core? Who are the partners that will help? Utilize tools and resources These are the questions 91��has received in conversations with members throughout 2013. Just as we delivered on your requests for free member education and training as part of dues, 2014 promises to provide you with the tools and resources you will need to respond to these challenges, demonstrate leadership, and formulate the vision necessary to make you and your teams invaluable. Keep asking, and we’ll keep listening. As we prepare to deliver these exciting new tools, programs and resources, I am asking you to do a few things to enhance your skills: <ul> <li>Achieve or renew your CHESP.</li> <li>Maintain your 91��membership and encourage a peer to join.</li> <li>Visit www.ahe.org often for the latest information on what’s coming and when.</li> <li>Visit www.aha.org – that’s right www.aha.org. The 91�� website has resources that will get you thinking about what keeps your executive management team awake at night. It will help you with the vision I spoke&nbsp;of earlier. It will help you ready yourself, not only for what may be coming but how you leverage what we will be delivering.</li> </ul> Of all the resources we will be launching in 2014, your CHESP, your membership and its benefits, the information offered on the websites above, and your passion for what you do will be your most valuable resources as you navigate the uncertainty of health care and your role. As you read the pages of this important issue of EXPLORE, take note that vision and leadership will be the key to success for all of us. Please take advantage of your membership benefits. ENGAGE in AHE’s webinars and courses, and leverage the knowledge and intellectual capital available to you from others who participate in courses and committee work. Consider getting involved and join them. Take advantage of the 91��and AHA library of publications that are inexpensive yet critical to our mission. Don’t forget to budget for and attend the best learning and networking event for the profession at EXCHANGE 2014 in Tampa, Fla., September 21–24. You will be surrounded by amazing talent, unfettered networking opportunities and an information repository that extends beyond the program dates. Make 2014 the year of vision, growth and success! Let us help you! Help yourself! ENJOY this issue of EXPLORE, and I hope to see yo u in Tampa! Sun, 23 Mar 2014 14:43:50 -0500 HCAHPS HCAHPS: Ways to Improve on the Environment Question /hcahps-ways-improve-environment-question By Carl Solomon, Sr., MBA, CHESP June 19, 2013 | Formats: Article | Content Areas: Administration | Tags: Environmental hygiene and sanitation, Evidence-Based Practice Solutions, HCAHPS, Management <hr /> Since 2008, the HCAHPS—Hospital Consumer Assessment of Healthcare Providers and Systems—survey has allowed valid comparisons across hospitals locally, regionally, and nationally. Starting last October, HCAHPS scores resulting from patient discharge surveys are being used in the calculation of value-based incentive payments in the Hospital Value-Based Purchasing (VBP) program. The HCAHPS survey asks recently discharged patients about aspects of their hospital experience that they are uniquely suited to address. The core of the survey contains 18 items that ask “how often” or whether patients experienced a critical aspect of hospital care, rather than whether they were “satisfied” with the care. The survey also includes four items to direct patients to relevant questions, three items to adjust for the mix of patients across hospitals, and two items that support Congressionally-mandated reports. (1) <h2>Inpatient Prospective Payment System: funds at risk</h2> Since July 2007, hospitals subject to the Inpatient Prospective Payment System (IPPS) annual payment update provisions must collect and submit HCAHPS data in order to receive their full annual payment update. IPPS hospitals that fail to publicly report the required quality measures, which include the HCAHPS Survey, may receive an annual payment update that is reduced by 2 percent. (1) <h2>HCAHPS &amp; hospital Value-Based Purchasing (VBP) Scoring</h2> The Hospital VBP program links a portion of IPPS hospitals’ payment from the Centers for Medicare &amp; Medicaid Services (CMS) to performance on a set of quality measures. The hospital’s total performance score (TPS) for FY 2013 has two components: the clinical process of care domain (70 percent of TPS), and the patient&nbsp;experience of care domain (30 percent of TPS). The HCAHPS survey is the basis of the patient experience of care domain. (1) Eight HCAHPS measures are employed in the hospital VBP: the six HCAHPS composites (communication with nurses, communication with doctors, staff responsiveness, pain management, communication and medicines, and discharge information); one new composite that combines the hospital cleanliness and quietness survey items; and one global item (overall rating of hospital). The percentage of a hospital’s patients who chose the most positive, or “Top-Box,” survey response in these HCAHPS dimensions is used to calculate the patient experience of care domain score. Below are details about what hospitals are doing to improve their Top-Box score1 on the cleanliness and quietness survey item. <h3>Cleanliness</h3> For cleanliness, the patient is asked the following question: “During this hospital stay, how often were your room and bathroom kept clean?” Departments that are responsible for cleaning patients’ rooms are having their staff perform the following duties: <ul> <li>Having a supervisor or manager check in on every newly admitted patient the same day they are admitted, if possible.</li> <li>Retraining their cleaning staff on how to properly clean an occupied patient room and bathroom.</li> <li>Using bleach-based germicidal cleaners or alcohol-free germicidal cleaners to help the room smell clean.</li> <li>Removing trash and soiled linen at the start of the day, and making a second round in the evening after dinner is served.</li> <li>Conducting a sample of daily room inspections before and after the room has been cleaned.</li> <li>Rotating the order of occupied room cleaning (e.g., the first room cleaned on a given day is not the first room cleaned the next day).</li> <li>Interviewing a few patients and family members on each patient care unit each day and leaving a business card.</li> <li>Providing AIDET Training (Announce, Introduce, Duration, Explanation, Thank You) to all newly hired staff, quarterly at staff meetings, and annually when giving performance evaluations. In applying AIDET to cleaning staff, these steps are followed: cleaning staff knocks on the door, asks if they may enter to empty trash/linen and/or clean the room, uses alcohol gel when entering and exiting the room (ensuring that the patient sees them rubbing their hands), makes eye contact with the patient and family, says their name and job title, explains what they will do and how much time it will take, asks if there is anything the patient needs, and thanks the patient and family for their time.</li> <li>Having generic department business cards available for cleaning staff to offer to the patient and family. If the patient is asleep, a business card may be left in the restroom. If the patient is out of the room when it is being cleaned, a business card should be left to let the patient/family know that the room and restroom have been cleaned.</li> <li>Placing a tent card on the over-bed table and toilet seat bands on the toilet when the room is discharge cleaned to let the patient know that the room was cleaned, and where to call if they have a cleaning need.</li> <li>Using a VIP (Very Important Patient) log to identify patients who communicated a cleaning concern, and following up with patients at least daily to ensure that their rooms and bathrooms are cleaned to their satisfaction.</li> <li>Designating an existing EVS supervisor as a quality assurance supervisor and trainer, or hiring one. The focus would be on inspecting an agreed number of patient rooms and following up with cleaning staff to correct deficiencies.</li> <li>Participating on conference calls, or attending seminars or conferences where there is an opportunity to learn what others are doing to improve their HCAHPS scores, and sharing best practices.</li> <li>Raising the bar on the caliber of the cleaning staff hired, to include being customer focused, pleasant, and knowledgeable about cleaning techniques.</li> </ul> <h3>Quietness</h3> For quietness, the patient is asked the following question: “During this hospital stay, how often was the area around your room kept quiet at night?” Departments are doing the following to make the patient environment quieter: <ul> <li>Using “Quiet Zone” signs in the corridors.</li> <li>Using noise meters</li> <li>Installing white noise machines that muffle the noise in the environment.</li> <li>Offering patients headphones and CDs with relaxing music.</li> <li>Offering patients ear plugs, which can be placed in the patient admit kit.</li> <li>Providing patients with a notice of construction or repair work that may create noise or vibrations.</li> <li>Having set quiet times each day when the lights are dimmed.</li> <li>Asking patients if they want their doors closed.&nbsp;</li> <li>Evaluating all transport carts and replacing noisy wheels/casters. This may include carts used by nursing, environmental services, material services and linen, facilities, nutritional services, and construction services.</li> <li>Turning down the alarm sound level on monitoring equipment if feasible. Some hospitals also have telemetry equipment monitoring away from the patient (e.g., in the nurses’ station).</li> <li>Having EVS departments perform work using heavy equipment only during the daytime. This includes using battery powered scrubbers, buffers, and other equipment.</li> <li>Using a portable lantern in multi-bed patient rooms to illuminate only the area where the employee is working during evening and overnight hours.</li> </ul> This is just a sample of the creative&nbsp;ways hospitals are striving to improve their patients’ perception of whether their room and bathroom is always clean, and whether noise is minimized near their room. I also recommend identifying hospitals in your region that have the highest Top Box scores and visiting them to learn how they are achieving excellence in HCAHPS. Also, hospital systems should freely share best practices information within their system to uncover new and creative ideas. HCAHPS is here to stay, so we must be ready, willing, and excited to meet its challenges. Wed, 19 Jun 2013 11:24:14 -0500 HCAHPS