hret curriculum: a new way of thinking about hcahps

Agency for Healthcare Research and QualityAgency for Healthcare Research and QualityAdvancing Excellence in Health CareAdvancing Excellence in Health Care • • www.ahrq.govwww.ahrq.gov

HCAHPS: HCAHPS: Update for TrusteesUpdate for Trustees

Mary Therriault RN MSMary Therriault RN MSSenior Director, Quality and Research InitiativesSenior Director, Quality and Research Initiatives

Healthcare Association of New York State Healthcare Association of New York State July, 2012July, 2012


HRET Curriculum: HRET Curriculum: A New Way of Thinking about HCAHPSA New Way of Thinking about HCAHPS

Hospital Consumer Assessment of Healthcare Providers and Systems

Advancing Advancing Excellence in Excellence in Health CareHealth Care What HCAHPS MeansWhat HCAHPS Means

HHow ow

CCan you an you

AAlways lways

HHelp elp

PPatients/ atients/ PProviders roviders

SSucceed? ucceed? 3

Advancing Advancing Excellence in Excellence in Health CareHealth Care

AHRQ/HRET Patient Safety AHRQ/HRET Patient Safety Learning Network (PSLN) Project Learning Network (PSLN) Project

HANYS, HANYS, HRET and AHRQ are partners in bringing HRET and AHRQ are partners in bringing you this free program of technical assistance for 6 you this free program of technical assistance for 6 months.months.

AHRQ has retained HRET to partner with health AHRQ has retained HRET to partner with health care leaders in creating Patient Safety Learning care leaders in creating Patient Safety Learning Networks to support hospitals that wish to use Networks to support hospitals that wish to use AHRQ’s patient safety improvement tools. AHRQ’s patient safety improvement tools.

HRET will support learning network members in HRET will support learning network members in using HCAHPS, as well other AHRQ patient safety using HCAHPS, as well other AHRQ patient safety tools in 25 States during 2012.tools in 25 States during 2012.4


AcknowledgementsAcknowledgements

This program is supported by the U.S. Agency for Healthcare This program is supported by the U.S. Agency for Healthcare Research and Quality (AHRQ) through a contract with the Research and Quality (AHRQ) through a contract with the Health Research and Educational Trust (HRET).Health Research and Educational Trust (HRET).

HRET is a charitable and educational organization affiliated HRET is a charitable and educational organization affiliated with the American Hospital Association, whose mission is to with the American Hospital Association, whose mission is to transform health care through research and education.transform health care through research and education.

AHRQ is a federal agency whose mission is to improve the AHRQ is a federal agency whose mission is to improve the quality, safety, efficiency, and effectiveness of health care for quality, safety, efficiency, and effectiveness of health care for all Americans.all Americans.

Faculty: Carrie Brady, MA, JD Faculty: Carrie Brady, MA, JD – Primary HCAHPS trainer Primary HCAHPS trainer – Former Connecticut Hospital Association staffer Former Connecticut Hospital Association staffer – Previous V.P. at Planetree Previous V.P. at Planetree

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Top four HCAHPS Priorities of over 430 Top four HCAHPS Priorities of over 430 hospitals participating in 18 HCAHPS PSLNs:hospitals participating in 18 HCAHPS PSLNs:

1.1. RN CommunicationRN Communication

2.2. ResponsivenessResponsiveness

3.3. Medication Communication*Medication Communication*

4.4. Discharge Information*Discharge Information*

** HCAHPS domains addressed by a patient- HCAHPS domains addressed by a patient-centered discharge processcentered discharge process

HCAHPS and HEN Priority Challenges: HCAHPS and HEN Priority Challenges: Care Transitions and Adverse Drug EventsCare Transitions and Adverse Drug Events

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Advancing Advancing Excellence in Excellence in Health CareHealth Care Our GoalOur Goal

7

To support hospital teams in To support hospital teams in effectively using HCAHPS as a effectively using HCAHPS as a tool for improving quality, safety, tool for improving quality, safety,

and the patient experience.and the patient experience.


Provide expertise, research, and practical Provide expertise, research, and practical toolstools

Harness participants’ institutional wisdom Harness participants’ institutional wisdom Build internal teams and external Build internal teams and external

communities for ongoing improvement workcommunities for ongoing improvement work

Our StrategiesOur Strategies

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In the United States,

how many HCAHPS surveys:

Will be administered

today?

Will be completed today?

9

Pop Quiz!


10

More than 25,000 surveys administered

More than 7,500 surveys completed

More than 7% of all hospitalized patientscomplete the survey

HCAHPS Today

Source: HCAHPS Executive Insight, October 2011. hcahpsonline.org. Centers for Medicare & Medicaid Services, Baltimore, MD. http://www.hcahpsonline.org/Executive_Insight/.


HCAHPS In a NutshellHCAHPS In a Nutshell

HCAHPS is a national HCAHPS is a national standardized survey of standardized survey of hospital inpatientshospital inpatients

27 questions27 questions 18 substantive questions18 substantive questions 4 screening questions4 screening questions 5 demographic questions 5 demographic questions


HCAHPS TopicsHCAHPS Topics

CMS reports individual scores for:CMS reports individual scores for: Cleanliness Cleanliness Quiet at night Quiet at night Overall rating Overall rating Willingness to recommendWillingness to recommend

CMS reports composite scores for 6 topics: CMS reports composite scores for 6 topics: Nurse Communication Nurse Communication Doctor CommunicationDoctor Communication Medication CommunicationMedication Communication ResponsivenessResponsiveness Pain ManagementPain Management Discharge InformationDischarge Information


Patients See Things Differently Patients See Things Differently Than ProvidersThan Providers

22% of 193 patients reported a “recent unsafe episode”22% of 193 patients reported a “recent unsafe episode”

More than 80% of the reported experiences were More than 80% of the reported experiences were classified by reviewers as “service quality incidents”classified by reviewers as “service quality incidents” 33% related to 33% related to waits and delayswaits and delays 21% related to 21% related to poor communication and information for poor communication and information for

patientspatients 13% related to 13% related to poor coordination of care among staffpoor coordination of care among staff

Source: Weingart SN et al. “Patient-Reported Safety and Quality of Care in Outpatient Oncology” Joint Commission Journal on Quality and Patient Safety; 33:2, 200713

Advancing Advancing Excellence in Excellence in Health CareHealth Care The Evidence is MountingThe Evidence is Mounting

HCAHPS Matters

Clinically

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HCAHPS Strategies HCAHPS Strategies Implemented by 25 Hospitals in Learning NetworkImplemented by 25 Hospitals in Learning Network

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Why HCAHPS Matters:Why HCAHPS Matters:

Value-Based Purchasing Value-Based Purchasing ImplicationsImplications

Advancing Advancing Excellence in Excellence in Health CareHealth Care VBP OverviewVBP Overview

DRG payments initially reduced by 1% in FY2013 DRG payments initially reduced by 1% in FY2013 reduction rises by 0.25% each year, ending with 2% reduction rises by 0.25% each year, ending with 2%

reduction in FY2017reduction in FY2017

Payments adjusted based on performance on Payments adjusted based on performance on HCAHPS (30%) and clinical process measures (70%)HCAHPS (30%) and clinical process measures (70%)

Hospitals may earn VBP points in two ways:Hospitals may earn VBP points in two ways: By achieving a certain level of performance or By achieving a certain level of performance or By improving their performanceBy improving their performance More points available for achievement than improvementMore points available for achievement than improvement

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Advancing Advancing Excellence in Excellence in Health CareHealth Care How Are We Doing?How Are We Doing?

18


New York New York Top Priorities for ImprovementTop Priorities for Improvement

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Leadership StrategiesLeadership Strategies Strategies for Partnering with Patients and FamiliesStrategies for Partnering with Patients and Families Workforce StrategiesWorkforce Strategies Data Use StrategiesData Use Strategies Performance Improvement StrategiesPerformance Improvement Strategies

Essential Elements to ConsiderEssential Elements to Consider

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HCAHPS is viewed as a valuable tool to help HCAHPS is viewed as a valuable tool to help organizations achieve multiple objectivesorganizations achieve multiple objectives

HCAHPS is part of a coordinated, comprehensive HCAHPS is part of a coordinated, comprehensive approach to partnering with patients and familiesapproach to partnering with patients and families

Everyone works together as a team to identify Everyone works together as a team to identify opportunities for improvement, innovate and implement opportunities for improvement, innovate and implement

strategies, and celebrate successstrategies, and celebrate success

Ideal ScenarioIdeal Scenario

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A comprehensive evidence-based system to A comprehensive evidence-based system to enhance teamwork and communication enhance teamwork and communication among healthcare professionalsamong healthcare professionals

HRET is the national training contractor HRET is the national training contractor Free curriculum and tools available at Free curriculum and tools available at

http://teamstepps.ahrq.gov/index.htm http://teamstepps.ahrq.gov/index.htm

Improving Communication Improving Communication through Team Trainingthrough Team Training

AHRQ TeamSTEPPS

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hret curriculum: a new way of thinking about hcahps

Documents

hcahps surveys

hcahps pslns

hcahps domains

hcahps priorities

quality ahrq

ahrq patient safety

systemswhat hcahps meanshow

hcahps executive insight