You Play an Important Role in Improving the Patient Experience and HCAHPS Rating

Dear Colleagues,

On Oct. 15, the Centers for Medicare and Medicaid Services (CMS) publicly released the quarterly results of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, a national survey mailed to randomly selected patients regarding the care they received during a recent hospital stay. Patients respond to 25 survey questions focused on nine domains—nurse communication, physician communication, responsiveness of staff, pain management, communication about medicines, cleanliness of room, quietness of the environment, discharge information and care transition—with "never," "sometimes," "usually" or "always." CMS assigns each domain a rating of one to five stars, and then provides a rating on patients' willingness to recommend the hospital and a summary rating of one to five stars.

HCAHPS scores are a valuable source of information for consumers seeking inpatient care. We heartily thank everyone for their work in delivering an "always" experience to our patients and families, who have high expectations about the clinical and emotional care we provide at The Johns Hopkins Hospital. When we receive high ratings on the survey, we know that we have met their expectations, and with that, we create loyal customers for life and positive word of mouth.

Unfortunately, The Johns Hopkins Hospital's overall rating dropped from four stars in the previously reported quarter to three stars. Our scores increased by one point in nurse communication, but they fell by a point in staff responsiveness and in willingness to recommend the hospital. This overall rating decline is due in part to the method CMS uses to rate the various categories. Stars are "graded on a curve," so although the majority of the HCAHPS domain mean scores did not change, as other organizations across the country improve, what used to be four-star ratings are now three. For example, an identical score in pain management and communication about medicines may have earned four stars in one quarter and three stars in another, and vice versa.

Our current overall rating of three out of five stars is based on survey information for calendar year 2014. It is certainly not indicative of the safe, innovative, high-quality care we deliver. That being said, we must accept that this method of evaluation is standardized across the nation for all hospitals and that nationally, hospitals are putting improvement processes in place that focus on the patient experience. We anticipate that our overall rating may not increase until spring 2016.

Each of us has a responsibility to do our part to consistently deliver a five-star "always" experience for our patients. Please recognize and reward staff members who are making a positive difference, and make sure all team members know how their role impacts the patient experience. If you have not done so already, please contact our Service Excellence team members. They will work with you to build the infrastructure and accountability within your units and among team members to set and achieve your goals. They will also connect you with our efforts in The Language of Caring.

We are counting on you to demonstrate leadership on this issue. Review the HCAHPS and other survey data with your team members, and collaborate on a strategy that will consistently provide our patients with a respectful, compassionate healing experience. 

Lisa Allen, chief patient experience officer, and our Service Excellence staff members are available to review your department's data with you. Please contact service@jhmi.edu for support and view the tools and resources on the Service Excellence website.

Thank you for your commitment to exceptional care and an outstanding patient experience.

Ronald R. Peterson
President
The Johns Hopkins Hospital and Health System
EVP, Johns Hopkins Medicine

Peter Pronovost, M.D., Ph.D.
Director, Armstrong Institute for Patient Safety and Quality
Senior Vice President for Patient Safety and Quality
Johns Hopkins Medicine

Judy A. Reitz, Sc.D.
Executive Vice President/COO
The Johns Hopkins Hospital
Vice President, Quality Improvement, Johns Hopkins Medicine

Lisa Allen, Ph.D.
Chief Experience Officer
Johns Hopkins Medicine