New HCAHPS Measure Would Evaluate Quality of Care Transitions

Friday, April 27th, 2012
This post was written by Patricia Donovan

Beginning in January, patients discharged from the hospital could be asked three key questions to assess the quality of their care transitions, as part of a proposed new measure in the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Survey.

As part of a proposed rule issued April 24, CMS wants patients about to be discharged to respond to the following three statements about the care transition:

  • During this hospital stay, staff took my preferences and those of my family or caregiver into account in deciding what my healthcare needs would be when I left.

  • When I left the hospital, I had a good understanding of the things I was responsible for in managing my health.

  • When I left the hospital, I clearly understood the purpose for taking each of my medications.

For the last question, patients would be able to indicate that they were not given any medication at discharge.

The proposed questions are based on the three-Item Care Transition Measure developed by the University of Colorado Health Sciences Center for the NQF Endorsement Project entitled “National Voluntary Consensus Standards for Quality of Cancer Care.” Detailed information on scoring methodology can be found on the Care Transition Measure Web site.

CMS also wants to add two “About You” items to the survey that would not be included in public reporting of the HCAHPS survey but would be employed in the patient-mix adjustment:

  • During this hospital stay, were you admitted to this hospital through the Emergency Room?

  • In general, how would you rate your overall mental or emotional health?

CMS said it has received numerous inquiries and requests from hospitals and researchers to add a survey item concerning patients’ overall mental health. Some researchers claim that mental health status is an important factor in how patients respond to HCAHPS survey items.

The HCAHPS Hospital Survey is a standardized survey instrument and data collection methodology for measuring patients’ perspectives on hospital care. In its current form, the HCAHPS survey contains 18 patient perspectives on care and patient rating items that encompass eight key topics: communication with doctors, communication with nurses, responsiveness of hospital staff, pain management, communication about medicines, discharge information, cleanliness of the hospital environment, and quietness of the hospital environment.

The survey also includes four screener questions and five demographic items, which are used for adjusting the mix of patients across hospitals and for analytical purposes. The current survey is 27 questions in length.

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