Healthcare Providers and Systems Assessment Term Paper

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Hospital Consumer Assessment of Healthcare Providers and Systems (HCAPHPS)

The Hospital Consumer Assessment of Healthcare Providers and Systems gives consumers a chance to compare the available health cares around the country and to decide on what care they would want. I will provide a scenario of how HCAHPS score of an organization can be improved. Also included into the method of improvement is a full data as well as impact analysis, a plan and also a timeline.

HCAHPS scores of Jacobi Medical Center

The hospital is situated in Bronx New York. The hospitals HCAHPS scores indicate that 63% of their patients were satisfied that the nurses were able to effectively communicate with them and another 47% of patients indicated that the help always came as soon as they needed it (Hospital Compare). 58% of the patients would recommend the facility and 55% would give the facility a favorable rating, a 9 or a 10 based on 1-10 scale (Hospital Compare). 75% indicated that doctors' communication was good and a good proportion, 80% of the patients, said that information on what to do during the period of recovery at home was given to them while 47% indicated that it was quiet in the evening in the area surrounding their rooms (Hospital Compare). In matters sanitation, 66% of the patients indicated that the bathrooms as well s the rooms were always clean (Medicare). 51% of the polled said that the staff gave explanations about the medications that were being given to them and 61% indicated that the pain was controlled well (Hospital Compare).

Part B: Score Analysis

The demographics at Jacobi hospital shows a hospital with good ethnic diversity (Jacobi Medical). 3% of the patients were Asian while 33% were blacks, 10% were whites while Hispanics made up 32% of the population and American Indians made up 1% (Jacobi Medical). Jacobi Hospital provides inpatient care that include infection isolation rooms, neonatal intensive care, psychiatric care, heart catheterization and neonatal intermediate care (Jacobi Medical). The outpatient care services has kidney dialysis, chemotherapy, HIV-AIDS services, women's health services, urgent care center and dental services. Ultrasound, MRI, CT scanner as well as diagnostic radio isotopic facility are available at imaging services (Jacobi Medical). The facility gives patients support services which cover cancer services, patient support groups, pastoral care services and government services help. 75% of patients in Jacobi Hospital gauged doctors' communication to be good. In this category the national average is 82% while the New York average is 77% (Hospital Compare). The patients who gave the hospital a rating of between 9 and 10 in the 1-10 scale were given a score of 55%. The nation averages 71% while New York averages 63% (Hospital Compare). The number of patients who indicated that help came when they needed it was 475 and the number compares well with New York's 615 and the nations 68% figures (Hospital Compare). We can compare Jacobi to two other facilities: St. Barnabas Hospital and Montefiore Medical Center. Montefiore scores 78% of patients as indicating good doctors' communication while St. Barnabas is rated at 80% of the polled patients (Hospital Compare). Montefiore figures indicate that 59% of the patients received explanations about the medications they were taking from the Hospital's staff while St. Barnabas scores 75% in the same category (hospital Compare). 67% of Montefiore's patients would recommend the facility to other patients while the number that would do the same in the case of St. Barnabas is 57% (Hospital Compare). The response rates for the survey for Montefiore, St. Barnabas and Jacobi were 21%, 13% and 15% respectively (Hospital Compare).

Educating patients could be the only means through which the issues raised in the HCAHPS survey are addressed given the factors that the questionnaire addresses (raise HCAHPS). How the survey was designed raises some issues that may be impossible to address operationally. The problems raised by the survey cannot be avoided because it is standardized and every facility must use the same template without adjusting survey questions to fit the needs of the specific hospital or manipulate it to avoid their areas of weaknesses or give clarifications of the intent of the question (Raise HCAHPS). The remaining tool available to them is expectations management which can be achieved through educating patients consistently and in a uniform manner. While patient education has been proved to better outcomes, a search on the internet reveals that the programs of HCAHPS are focused on operational issues, with very little alterations on the programs being used for patient education (Raise HCAHPS).

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There are no efforts that have been put into place to ensure management of patient expectations by way of a uniform and well planned education program. A search in the MEDLINE/PUBMED medical publication search engine does not reveal any (Raise HCAHPS). Sociocultural differences between providers and patients have had influence on communication between them and how decisions are made (Cross-Cultural Care). There is evidence linking clinician-patient communication to the satisfaction of patients, health outcomes and adherence. Failure to recognize these sociocultural differences may result in low quality care (Cross-Cultural Care). HCAHPS will have an impact on hospital medical reimbursements through the measuring of communication between patients and clinicians and having it as a major factor in determining satisfaction scores (Cross-Cultural Care).Study efforts on effects of Cultural competency on the satisfaction of patients is promoted by the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Cultural Competence Item Set (Cross-Cultural Care).

While it has been a moral obligation for medical facilities to give high quality experience to patients, the tying of reimbursements to the scores of HCAHPS is making it a priority. Through the survey, patients in hospitals around the country use 27 categories to rate the experience of their stay in these facilities using several parameters like the communication effectiveness between the medics and them and the management of pain as well as sanitation and levels of quietness (Letournea, 2014). The payments to hospitals in any given financial year is pegged on the resulting scores and hospitals can gain or lose up to 1.5% of Medicare payments assigned to them in the 2015 fiscal year (Letournea, 2014). Notably, CMS is tightening the belt, and in the next few years there will be major changes and we could see up to 2% of the dollars being at stake by the 2017 fiscal year (Letournea, 2014). With the amounts of money at stake increasing, the facilities are seeking better ways and strategies to better the experience of their patients and also improve the score they get on HCAHPS.

Part C: Reasons for Jacobi's HCAHPS Score

One main reason that could explain the low Jacobi's HCAHPS scores could be as simple as communication. It is noteworthy that the figures given for good communication by doctors and nurses are significantly low. The doctors' is at 75% while the nurses' is at 63%. These are figures that should be hitting the 100% mark because there is nothing that could explain bad communication in such environments. There is no way that doctors can work with patients if communication is not good. Darin Vercello, in his blog titled " Simultaneously Enhance HCAHPS Scores and Patient Flow," writes that good communication is one thing in medicine that is often highly appreciated and praised by families and patients. Phrases being associated with good HCAHPS scores have always highlighted effective communication between medics and patients. The patients appreciate that the doctor sat them down and talked with them or that the nurse gave a given explanation. You will not hear a patient saying that his doctor gave the best antibiotic (Radak, 2012). In light of these revelations, what then can the survey do to help improve the techniques being used in communication? I think they can make use of better techniques that will help patients recall instructions given to them and also make use of more interpretation services.

Poor patient education can also explain the nature of Jacobi's HCAHPA in certain jurisdictions. For instance, while all patients should be instructed on what exactly to do during the period of recovery, the figure is a disappointing 80%. Another figure that should be better is the number of patients who received explanations about the medications they were taking. The figure is actually just 51% (Hospital Care). There shouldn't be any patient that leaves a hospital without adequate information on how to use their medication or how their recovery period should be like (Writer Thoughts). Improper usage of medication can cause more harm to the patient and result in even worse health conditions. A doctor or nurse interacting with a patient should consider the moment a chance to give the patient a proper education about his illness, the medication he or she will take, what follow-ups to make and other plans after discharge (Writer Thoughts). To ensure that the patients are not detached but involved in the care.....

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