Healthcare Providers And Systems Survey Paper

The Hospital Consumer Assessment of Healthcare Providers (HCAHPS) began in 2006 with a 27 question survey that is distributed to discharged patients. This survey process was originally designed to help patients compare hospitals in their area to be able to make an informed choice for their healthcare needs. In January 2013, five additional questions were added to the survey. Beginning this year, Medicare reimbursement rates to a hospital are tied to the hospital’s patient satisfaction scores. Therefore, hospitals are continually looking for ways to improve

Information obtained for this project included researching hospital scores from the Centers for Medicare & Medicaid Services (CMS) hospital consumer assessment of healthcare providers and systems (HCAHPS), The Leapfrog Group, American Hospital Directory, an interview with the Vice President/Chief Nursing Officer (VP/CNO) of the facility, a letter from the President/Chief Administrative Officer (CAO) of the facility, Covenant Health websites, Medicare website, the Joint Commission website, national practice standards, as well as personal knowledge gained while working in the facility.

The HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) survey is the first national, standardized, publicly reported review of patients ' perspectives of hospital care. While many hospitals have collected information on patient satisfaction for their own internal use, until HCAHPS there was no national standard for collecting and publicly reporting information about patient experience of care that allowed valid comparisons to be made across hospitals locally, regionally and nationally.

Nurse staffing and how it relates to the quality of patient care has been an important issue in the field of nursing for quite some time. This topic has been particularly popular recently due to the fact that there is an increasing age among those who make up the Baby Boomer era in the United States. There will be a greater need for nurse staffing to increase to help accommodate the higher demand of care. Although nursing is “the top occupation in terms of job growth,” there are still nursing shortages among various hospitals across America today. The shortage in nurses heavily weighs on the overall quality of care that each individual patient receives during their hospital stay (Rosseter, 2014).

Healthcare is in a constant state of change with movements that impact rates, access and quality of care. Hospitals have become more competitive due to the rising cost of care delivery and the reduction in reimbursement from payers. This causes difficulty in delivering quality care to all patients, which is being measured by mandated patient perception surveys, Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). HCAHPS scores are part of value

quality of patient care, and can be implemented in practice, to provide solutions to nursing

This paper will describe current quality outcome measures and the significance for improving medical care. Organizational accountability and transparency has improved with the emergence of Hospital Inpatient Quality Reporting (IQR) programs and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPs). This article will review the role of the nurse manager in creating a culture for quality care as well as the nurse for meeting organizational and patient expectations. Organizations like The Joint Commission (JC), Agency for Healthcare Research and Quality (AHRQ), Centers for Medicare and Medicaid Services (CMS), and The American Nurses Association (ANA) have been critical in establishing standards for quality. This paper will also report on the most recent hospital statistics and steps taken to improve HCAHP scores and reduce readmission rates at the University of Tennessee Medical Center in Knoxville (UTMCK). Statistics at UTMCK will also be compared to the Tennessee and National averages found on the Medicare website Hospital Compare. The aim of this paper is to explore if healthcare system initiatives are improving quality and enhancing patient outcomes.

Historically, a BSR was given verbally at the nursing station with frequent interruptions, taped on the recorder or a written paper report without the patient being involved in their care. As the healthcare industry has become more of a patient-centered, the hospitals are participating in a publicly reported government HCAHPS survey- a composite scale score that measure patient’s hospital experience through a metric satisfaction survey. An effective handoff is critical when transferring any medical information of a patient’s continuity of care from one nurse to another. According to the Health Professions Education: A Bridge to Quality: “all health professionals should be educated to deliver patient-centered care as members of an inter-disciplinary team, emphasizing evidence-based practice, quality improvement approaches, and informatics.” (IOM, 2013). This paper analyzes an overview of nurse’s survey, direct observation on the BSR, a literature summary, nursing challenges and recommendations that might improve patient safety and quality of care.

Nursing-sensitive indicators are defined by the American Nursing Association (ANA) as “indicators that reflect the structure, process and outcomes of nursing care” (ANA, 2014). These indicators help define how nursing care is given by measuring the amount of nursing staff, skill level of the nursing staff, and the education level of nursing staff. These indicators depict the quality of care provided to patients and the outcomes of the care provided. Careful tracking of these indicators provides evidence for keeping current practices or for implementing new policy and procedures. A formal set of indicators measuring the impact nursing interventions have on patient care was not implemented until 1998 (Montalvo, I. (2007). With the establishment of the National Database of Nursing Quality Indicators (NDNQI), hospitals and other care settings are able to assess how nursing interventions impact patient outcomes, quality of care, and the overall work environment in health care facilities. Nursing-sensitive indicators are a quality improvement measure used to determine how the quality of nursing care is evaluated in hospitals and other healthcare facilities. Nurse sensitive indicators allow healthcare facilities to evaluate how the care they are providing is following evidence-based practices and how they can improve their practices to achieve better patient outcomes. The American Nurses Association is promoting these indicators as the definitive standards for patient care

The gaps that show areas of improvement are of the nurse’s perceived service and the patient’s perceived experience based on the patient’s expectations (Dabney and Tzang 2013). A patient’s expectations are modeled by past experiences, culture, personal needs, and word of mouth from other patient experiences. If a provider does not implement a patient-centered approach to patient care the patient’s needs cannot be met due to the gap in patient expectations and perceived service (Dabney and Tzang 2013).

Patients want and expect to receive high quality care. Nurses want to provide the best care possible to their patients and like everybody else; want a pleasing job environment. Hospitals, on the other hand, are expected to provide a safe environment to patients, have enough nursing staff and remain profitable (Keller, Dulle, Kwiecinski, Altimier & Owens, 2013). The ultimate goal is to improve quality of care and patient safety across the United States; therefore, all the different interests of these major stakeholders should be taken into

Survey of patient’s experiences is important source of information of the quality of health care provided by the particular hospital, which allows patients to compare the hospitals in the area. The HCAHPS star rating of Gulf Coast Hospital and Bay Medical Center is two stars, while Sacred Heart Hospital is rated with four stars on the excellence of care. The outliner indicators for Gulf Coast Medical Center in the survey of patients’ experiences on the question: “How often did patients receive help quickly from the hospital staff?” shows that 74% patients pick the answer “always communicated well”, that is slightly lower than national average with 79%. The survey question “How often were the patients’ rooms and bathrooms kept clean” only 61% of the patients pick that their bathroom and room were “always clean” that is much lower than the national average 74% and only 47% of the patients understood the care that was provided when they were

Two types of data were collected through surveys, both before and after implementation of the combined approach (Sand-Jecklin and Sherman,2014). The first data was on nurses’ point of view with regards reporting process, and the second on patients view regrading nursing care. The baseline survey included 233 patients and 148 nurses, while the survey three months into the implementation period included 157 patients and 98 nurses. The final survey, 13 months into the impanation, was completed by 154 patients and 54 nurses. The patient survey also included responses from patient families. These were 70, 72, and 53 responses for baseline survey, three-month postimplementation surveys, and 13-month postimplementation surveys.

A study conducted by Young, Minnick, and Marcantonio (1996) compared the opinions of more than a thousand staff nurses, numerous nurse managers, and more than two thousand patients from 17 hospitals regarding certain aspects and perceptions of patient care needs. Interestingly, staff nurse and managers

Although research is available on patients ' expectations of and satisfaction with nursing care in hospitals, less is known about their perspectives of care in ambulatory settings, where more care is being delivered.