H-CAHPS survey reflects patient experiences

When a patient needs to choose a hospital, she can find out how well her local hospital scores on heart attack, pneumonia care or other process and outcomes measures. But until recently, she would not be able to find information about the experiences other patients have had. This incomplete state of hospital quality data is now changing.

Starting March 28, data on patient experiences in the hospital was added to the federal government's Hospital Compare Web site. Patients' feedback was drawn from a 27-question survey developed by the Agency for Healthcare Research and Quality (AHRQ), and reflects the issues of greatest concern to patients. Data about patients' experiences in 2,500 hospitals has already been uploaded to the site; by the end of the year, information from most of the nation's hospitals will be available.

In the H-CAHPS survey, patients answered questions about their hospital care, such as:

Based on patients' feedback published in 2007, it's clear that hospitals and health professionals are doing some things very well. At the same time, they clearly have more work to do. For example, 84% of patients said that doctors always treated them with courtesy and respect. More than three-fourths (77%) said they received that same treatment from nurses.

On the other hand, 20% of respondents reported they never received written information about symptoms or problems to watch for after being discharged. As we know, inadequate discharge planning is not only confusing to patients but can lead to medical errors, adverse events and re-hospitalization.

As a physician and health service researcher, I fully appreciate that a speedy response to a call button or a quiet room at night does not automatically translate to the best quality care. Getting information about post-discharge care is, however, very important to both peace of mind and good outcomes. Research shows that 15% of patients who don't understand instructions when they are being discharged return to the hospital, are re-admitted, or end up in the emergency room within two weeks.

For too long, patients' opinions about their hospital care have been either ignored or examined from a narrow, image-driven perspective. Data from the new H-CAHPS survey provides information that will help patients make more informed decisions and guide providers in their ongoing quality improvement efforts.

Carolyn Clancy, MD, is the director of the U.S. Agency for Healthcare Research and Quality.