Glossary of Patient Experience Measures
The H-CAHPS® (Hospital Consumer Assessment of Healthcare Providers and Systems) survey is composed of multiple questions that address several aspects of the hospital experience (communication with doctors, communication with nurses, responsiveness of hospital staff, cleanliness and quietness of hospital environment, pain management, communication about medicines, discharge information, overall rating of hospital, and recommendation of hospital).
Patients are asked to respond to the questions with the options to answer each with Always, Usually, Sometimes or Never. BIDMC began using this survey in July, 2006, and CMS posts our performance on their website HospitalCompare website. For more information on H-CAHPS, please go to www.hcahpsonline.org.
Communication with Nurses
Score reflects the percent of time that patients answered "Always" when asked if nursing staff "Communicated well." Included in the Communication with Nurses score are the responses to the particular questions of:
- How often did nurses treat you with courtesy and respect?
- How often did nurses listen carefully to you?
- How often did nurses explain things in a way you could understand?
Patients and families value the courtesy and respect with which our nurses listen to patient concerns, share information, and provide clear explanations of patient's care. To improve our performance, we have initiated a communication program directing all caregivers (nurses, hospital staff and physicians) to ensure that each patient understands who is caring for them and involves each patient in their plan of care. To help with this effort, we are currently in the process of installing new whiteboards on all inpatient units. These new whiteboards provide space to write the name of the patient's nurse, patient care technician, doctor(s) and other care providers who may be working with the patient. The whiteboards also provide a space for the patient's "Plan of Care," as well as a space for patients and families to write their own questions to be answered by the doctor or nurse.
Data Source: BIDMC H-CAHPS® Survey performance compiled by Press Ganey, and reported quarterly to Center for Medicare and Medicaid (CMS). Note that BIDMC performance data reflects more recent performance than that posted currently on the CMS HospitalCompare website. Comparison data for Like Acadmic Medical Centers (Custom Comparative) and National Database Participants provided by Press Ganey.
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Responsiveness of Hospital Staff
Score reflects the percent of time that patients answered "Always" when asked about the reponsiveness of hospital staff. Bundled in the Responsiveness of Hospital Staff score are the responses to the particular questions of:
- Call button help as soon as you wanted?
- Help toileting soon as you wanted?
Patients often provide feedback regarding the promptness of staff in assisting patients with their personal needs. To improve our performance in this element of patient care, we have implemented a program entitled "We Promise…" on all medical-surgical units across BIDMC. Our commitment, or "Promise," to our patients is to see them every hour, to attend to their bathroom and hygiene needs and to ensure they are comfortable and safe. BIDMC anticipates that by proactively addressing our patients' needs through regularly scheduled check-ins by hospital staff, patients will be less reliant on the call button and more likely to receive assistance as soon as they need it. "We Promise..." emphasizes that our patients' safety and comfort are our primary goals.
Data Source: BIDMC H-CAHPS® Survey performance compiled by Press Ganey, and reported quarterly to Center for Medicare and Medicaid (CMS). Note that BIDMC performance data reflects more recent performance than that posted currently on the CMS HospitalCompare website. Comparison data for Like Acadmic Medical Centers (Custom Comparative) and National Database Participants provided by Press Ganey.
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Communication with Doctors
Score reflects the percent of time that patients answered "Always" when asked about how well physicians communicated with them. Bundled in the Communication with Doctors score are the responses to the particular questions of:
- Doctors treat you with courtesy and respect?
- Doctors listen carefully to you?
- Doctors explain in a way you understand?
We have initiated a communication program directing all caregivers (nurses, hospital staff and physicians) to ensure that each patient understands who is caring for them and involves each patient in their plan of care. Additionally, Nurse Managers on all inpatient units have begun daily patient rounds, allowing them to meet patients and families and ensure their care needs are being met.
BIDMC's "Patient Pathways" series provides patients with an educational resource detailing what s/he can expect to experience before, during and after surgery. Physicians typically review the pathway with the patient during a pre-operative appointment to help prepare the patient and answer questions that s/he may have. The information provided in the tool is comprehensive of procedural information and tests, nutrition, activity, comfort, education, etc., and serves as a great guide for a healthy dialogue between physicians and patients.
Data Source: BIDMC H-CAHPS® Survey performance compiled by Press Ganey, and reported quarterly to Center for Medicare and Medicaid (CMS). Note that BIDMC performance data reflects more recent performance than that posted currently on the CMS HospitalCompare website. Comparison data for Like Acadmic Medical Centers (Custom Comparative) and National Database Participants provided by Press Ganey.
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Pain Management
The percentage of patients responding "always" when asked how often their pain was well controlled while in the hospital, and that hospital staff did everything they could to help patients with their pain to ensure patient comfort. These measures provide insight into how well staff monitor and assess each patient's pain, and the efforts made to ensure patient comfort to promote healing.
Pain management and ensuring patient comfort is an important factor in promoting recovery. To improve our performance, we make pain assessment part of our discussion with patients during hourly rounding. Our goal is to proactively check in with patients about the pain they may be experiencing and do everything we can to keep it well-controlled.
Data Source: BIDMC H-CAHPS® Survey performance compiled by Press Ganey, and reported quarterly to Center for Medicare and Medicaid (CMS). Note that BIDMC performance data reflects more recent performance than that posted currently on the CMS HospitalCompare website. Comparison data for Like Acadmic Medical Centers (Custom Comparative) and National Database Participants provided by Press Ganey.
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Communications about New Medications
The percentage of patients responding "always" when asked about the frequency and consistency with which hospital staff explained the purpose of new medications administered to them during their hospital stay and any side effects that medication might cause to the patient. Patients should always be aware of any medications administered to them, and of any side effects that patients might experience. Patients are encouraged to ask questions and communicate any concerns about medication or side effects immediately to their care team, to ensure patient safety.
Medication safety is a partnership between patients and their care team. We are currently evaluating the patient education resources we have available to better explain potential side effects of any new medications you may receive while in the hospital. In addition, we encourage you to always ask questions of your care team. If you need more information about a medication, please do not hesitate to ask your nurse or physician.
Data Source: BIDMC H-CAHPS® Survey performance compiled by Press Ganey, and reported quarterly to Center for Medicare and Medicaid (CMS). Note that BIDMC performance data reflects more recent performance than that posted currently on the CMS HospitalCompare website. Comparison data for Like Acadmic Medical Centers (Custom Comparative) and National Database Participants provided by Press Ganey.
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Room and Bathroom Always Kept Clean
Score reflects the percent of time that patients answered "Always" when asked how often their room and bathroom were kept clean.
Patients want to be certain that their surroundings are clean and comfortable. Patient survey feedback emphasizes the importance patients place on their environment. To further improve, BIDMC Housekeeping Services has introduced a multi-dimensional new program involving: more frequent rounding by staff and supervisors, notification of housekeeping services and visits while patients are away from their room, additional staff training to strengthen communication and service skills, increased quality assurance checks, and new equipment. This approach is designed to provide a clean and comfortable environment for all patients and to address patient needs in a timely manner.
Data Source: BIDMC H-CAHPS® Survey performance compiled by Press Ganey, and reported quarterly to Center for Medicare and Medicaid (CMS). Note that BIDMC performance data reflects more recent performance than that posted currently on the CMS HospitalCompare website. Comparison data for Like Acadmic Medical Centers (Custom Comparative) and National Database Participants provided by Press Ganey.
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Quiet Room at Night
Score reflects the percent of time that patients answered "Always" when asked if the the area around your room quiet at night.
We are focused on minimizing noise at night so our patients can get the sleep they need to heal and recover. We recently rolled out our Silent Hospitals Help Healing (SHHH) program to reduce noise at night and promote sleep for our patients. Quiet Hours are from 9pm to 6am, and we ask staff, patients, and visitors to respect this time. Hallway lights dim, doors to patient rooms are shut if possible, ear plugs are provided to all patients, conversations move away from hallways and common areas, and staff will be monitoring the noise level using a visible noise meter displayed on the unit. These are just some of the steps being taken to ensure the inpatient environment is a place to rest and heal.
Data Source: BIDMC H-CAHPS® Survey performance compiled by Press Ganey, and reported quarterly to Center for Medicare and Medicaid (CMS). Note that BIDMC performance data reflects more recent performance than that posted currently on the CMS HospitalCompare website. Comparison data for Like Acadmic Medical Centers (Custom Comparative) and National Database Participants provided by Press Ganey.
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Overall Rating of BIDMC
After answering all other questions on the survey, patients answered a separate question that asked for an overall rating of the hospital. Ratings were on a scale from 0 to 10, where "0" means "worst hospital possible" and "10" means "best hospital possible." Score reflects the percent of patients responding who gave BIDMC a rating of 9 or 10 on a scale from 0 (lowest) to 10 (highest). This measure provides insight into the overall patient experience and combined with other satisfaction measures, helps us identify opportunities for improvement.
Data Source: BIDMC H-CAHPS® Survey performance compiled by Press Ganey, and reported quarterly to Center for Medicare and Medicaid (CMS). Note that BIDMC performance data reflects more recent performance than that posted currently on the CMS HospitalCompare website. Comparison data for Like Acadmic Medical Centers (Custom Comparative) and National Database Participants provided by Press Ganey.
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Likelihood to Recommend BIDMC
The percent of patients responding to the likelihood of recommending BIDMC to their family and friends for inpatient care. The score reflects the percent of time that patients answered "Definitely Yes". This measure provides insight into the overall patient experience and combined with other satisfaction measures, helps us identify opportunities for improvement.
Data Source: BIDMC H-CAHPS® Survey performance compiled by Press Ganey, and reported quarterly to Center for Medicare and Medicaid (CMS). Note that BIDMC performance data reflects more recent performance than that posted currently on the CMS HospitalCompare website. Comparison data for Like Acadmic Medical Centers (Custom Comparative) and National Database Participants provided by Press Ganey.
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Ambulatory Patient Satisfaction Performance
Access to Care
Score reflects the percent of time that patients answered "Very Good" when asked questions about how easy it was to contact and schedule an office visit. Bundled in the Access to Care score are the responses to the particular questions about:
- Ease of getting clinic on the phone
- Convenience of our office hours
- Ease of scheduling your appointment
- Courtesy of registration staff
Patients recognize and appreciate BIDMC's efforts to improve promptness, courtesy, and ease in which clinic appointments are scheduled. BIDMC continues to expand its program among ambulatory practices to improve the quality, helpfulness and promptness of telephone and waiting room staff. By engaging a team of "mystery shoppers", we provide prompt feedback to our staff to improve their responsiveness and ability to provide efficient and patient-focused assistance at every interaction. Participating practices have reduced wait times for new patients by 10 business days since the inception of the program and those practices can now routinely offer care within a week.
Data Source: BIDMC performance is compiled by Press Ganey, an independent survey organization, and reported quarterly to BIDMC. Comparison data for Like Acadmic Medical Centers (Custom Comparative) and National Database Participants is also provided by Press Ganey.
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Information about Waits & Delays During Your Visit
Score reflects the percent of time that patients answered "Very Good" when asked about the length of wait before going to an exam room, and information provided to patients about delays experienced waiting to be seen.
Patients express frustration with longer than anticipated wait times and lack of information about delays. In response to this feedback, many ambulatory practices are piloting methods of systematically informing patients of delays in the waiting room. Some practices, such as OB/GYN and Gastroenterology, consistently update a white board so that patients are apprised of any delays at the moment of check-in. Hematology Oncology assigns a liaison to check in with those waiting every 20 minutes.
We are also assessing causes for unanticipated waits and delays, particularly in the exam rooms. This year, we will initiate a multi-year efficiency project in partnership with our physician leaders. This effort will start with observation, measurement and experimentation with various interventions in a practice where delays are a significant problem.
Data Source: BIDMC performance is compiled by Press Ganey, an independent survey organization, and reported quarterly to BIDMC. Comparison data for Like Acadmic Medical Centers (Custom Comparative) and National Database Participants is also provided by Press Ganey.
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Experience with Care Provider
Score reflects the percent of time that patients answered "Very Good", and reflects patients reponses to questions regarding:
- Friendliness/courtesy of the care provider
- Explanations the care provider gave you about your problem or condition
- Concern the care provider showed for your questions or worries
- Care provider's efforts to include you in decisions about your treatment
- Information the care provider gave you about medications
- Instructions the care provider gave you about follow-up care
- Degree to which care provider talked with you using words you could understand
- Amount of time the care provider spent with you
- Your confidence in this care provider
- Likelihood of your recommending this care provider to others
These questions are not only designed to give us perspective on how we listened and responded to you, but also allow us to understand the quality and quantity of information your care provider shared with you.
Data Source: BIDMC performance is compiled by Press Ganey, an independent survey organization, and reported quarterly to BIDMC. Comparison data for Like Acadmic Medical Centers (Custom Comparative) and National Database Participants is also provided by Press Ganey.
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Teamwork Among Staff
The percent of patients responding "Very Good" when asked "How well staff worked together" during their outpatient visit. Coordination of your care and the team work of our staff are important to good care. Patients' responses this question give us a broader sense of their experience, and help us identify opportunities for additional improvement.
In 2009, we launched an initiative across all ambulatory clinics and the Emergency Department, called "Going from Good to Great." This program helps frontline staff view their work from a patient's perspective and ensure consistently attentive, efficient, friendly and respectful service. Clinic staff are empowered to proactively address service needs or issues and identify opportunities to make each patient's visit more personable by being attentive to individual needs, sharing information on delays, providing assistance with directions, listening, and in some clinics, providing refreshments during waits.
The program is designed to reinforce the fact that all BIDMC employees, no matter what department they are in, are united by a commitment to our patients.
Data Source: BIDMC performance is compiled by Press Ganey, an independent survey organization, and reported quarterly to BIDMC. Comparison data for Like Acadmic Medical Centers (Custom Comparative) and National Database Participants is also provided by Press Ganey.
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Likelihood to Recommend
Score reflects the percent of patients responding "Very Good" when asked about the likelihood of recommending BIDMC for ambulatory care to their family and friends. This measure provides insight into the overall patient experience and combined with other satisfaction measures, helps us identify opportunities for improvement.
Data Source: BIDMC performance is compiled by Press Ganey, an independent survey organization, and reported quarterly to BIDMC. Comparison data for Like Acadmic Medical Centers (Custom Comparative) and National Database Participants is also provided by Press Ganey.
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