Surveys are used by hospitals to evaluate patient satisfaction and to improve general hospital operations. Collected satisfaction data is usually represented to the hospital administration by using ...statistical charts and graphs. Although such visualization is helpful, typically no deeper data analysis is performed to identify important factors which contribute to patient satisfaction. This work presents an unsupervised data-driven methodology for analyzing patient satisfaction survey data. The goal of the proposed exploratory data analysis is to identify patient communities with similar satisfaction levels and the major factors, which contribute to their satisfaction. This type of data analysis will help hospitals to pinpoint the prevalence of certain satisfaction factors in specific patient communities or clusters of individuals and to implement more proactive measures to improve patient experience and care. To this end, two layers of data analysis is performed. In the first layer, patients are clustered based on their responses to the survey questions. Each cluster is then labeled according to its salient features. In the second layer, the clusters of first layer are divided into sub-clusters based on patient demographic data. Associations are derived between the salient features of each cluster and its sub-clusters. Such associations are ranked and validated by using standard statistical tests. The associations derived by this methodology are turned into comments and recommendations for healthcare providers and patients. Having applied this method on patient and survey data of a hospital resulted in 19 recommendations where 10 of them were statistically significant with chi-square test’s p-value less than 0.5 and an odds ratio z-test’s p-value of more than 2 or less than −2. These associations not only are statistically significant but seems rational too.
An adult trauma center identified pain management as a potential area for improvement. Pain management is at the height of discussion in medical centers across the United States. The Hospital ...Consumer Assessment of Healthcare Provider and System (HCAHPS) scores relating to pain management were consistently low (<5th percentile). This project was designed to use a collaborative and systematic approach to pain management to improve HCAHPS pain management scores. This is an evaluation of a quality improvement project using a before-and-after design with historical control. Using HCAHPS data to evaluate patients' pain management perceptions, an integrative three-pronged approach was developed and implemented: (1) development of a trauma nurse leadership program, (2) collaboration with pain management providers, and (3) modifications made to the trauma admission order set. Trauma nurse leaders educated patients and families regarding pain management goals and expectations utilizing a standardized script. HCAHPS survey data obtained before and after the intervention showed a significant improvement in patient satisfaction. HCAHPS scores on the three pain questions prior to intervention in Quarters 2 and 3 (Q2-3) 2017 had a mean of less than the 5th percentile. After intervention, HCAHPS scores on the three pain questions improved to a mean of more than the 60th percentile on Q4 2018. Implementation of a pain management strategy involving a three-pronged approach of a dedicated trauma nurse leadership program, collaboration with a pain management team, and evaluation and modification of a trauma admission order set was associated with an improvement in communication about pain with the trauma patients and HCAHPS pain satisfaction scores.
Reports have shown that ambulatory primary care practices that include patients and families in their quality improvement efforts have many benefits including better relationships and interactions ...with patients. In this paper, we describe our experience of involving our patients, family, and staff who are members of or Patient and Family Advisory Council (PFAC) in our quality improvement efforts related to patient experience. For a year, members of the PFAC suggested creative implementations to our office policies and workflow to improve satisfaction scores on the Clinician and Group Consumer Assessment of Health care Providers and Systems survey in key areas: information about delays, wait times in clinic, and convenience of appointments.
Medicare hospital Value-based purchasing (VBP) program that links Medicare payments to quality of care will become effective from 2013. It is unclear whether specific hospital characteristics are ...associated with a hospital's VBP score, and consequently incentive payments.The objective of the study was to assess the association of hospital characteristics with (i) the mean VBP score, and (ii) specific percentiles of the VBP score distribution. The secondary objective was to quantify the associations of hospital characteristics with the VBP score components: clinical process of care (CPC) score and patient satisfaction score.
Observational analysis that used data from three sources: Medicare Hospital Compare Database, American Hospital Association 2010 Annual Survey and Medicare Impact File. The final study sample included 2,491 U.S. acute care hospitals eligible for the VBP program. The association of hospital characteristics with the mean VBP score and specific VBP score percentiles were assessed by ordinary least square (OLS) regression and quantile regression (QR), respectively.
VBP score had substantial variations, with mean score of 30 and 60 in the first and fourth quartiles of the VBP score distribution. For-profit status (vs. non-profit), smaller bed size (vs. 100-199 beds), East South Central region (vs. New England region) and the report of specific CPC measures (discharge instructions, timely provision of antibiotics and beta blockers, and serum glucose controls in cardiac surgery patients) were positively associated with mean VBP scores (p<0.01 in all). Total number of CPC measures reported, bed size of 400-499 (vs. 100-199 beds), a few geographic regions (Mid-Atlantic, West North Central, Mountain and Pacific) compared to the New England region were negatively associated with mean VBP score (p<0.01 in all). Disproportionate share index, proportion of Medicare and Medicaid days to total inpatient days had significant (p<0.01) but small effects. QR results indicate evidence of differential effects of some of the hospital characteristics across low-, medium- and high-quality providers.
Although hospitals serving the poor and the elderly are more likely to score lower under the VBP program, the correlation appears small. Profit status, geographic regions, number and type of CPC measures reported explain the most variation among scores.
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Dostopno za:
CEKLJ, DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The Hospital Consumer Assessment Health Providers and Systems survey on patient satisfaction has taken on greater significance with the introduction of the Hospital Value Based Purchase program by ...the Center for Medicare and Medicaid Services. Content analysis of open-ended comments by patients has seen limited use in spite of the insight in can provide into factors contributing to patient (dis)satisfaction. This article uses an emergency department setting to gain insight from patient experience.
Health care reimbursements are changing from a medical care-based scale to a pay-for-performance system. The Value-Based Purchasing Program uses clinical quality indicators along with the Hospital ...Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey as part of an incentive program for hospitals to gain reimbursements based on the patient care experience. Although clinical quality indicators are often outside of a sonographer’s scope of practice, several of the HCAHPS items are a routine part of a sonographer’s daily duties, such as communication and responsiveness to the patient and cleanliness of the facility. Providing education concerning HCAHPS and Value-Based Purchasing to clinical sonographers, as well as student sonographers, will improve patient interactions and assist hospitals in gaining reimbursements.
Abstract Background Low-income, publicly insured admissions historically cost more to treat than does the average patient. To ensure that hospitals are reimbursed an adequate amount for care of ...indigent populations, Medicare reimburses hospitals an additional percentage amount according to federally set financial schedule. At 15% of a disproportionate patient percentage, a hospital is reimbursed an extra 2.5% of the standard prospective payment rate. Objective This research seeks to determine whether hospital qualification as a Medicare Disproportionate Share Hospital results in higher patient experience ratings. Methods A regression discontinuity method was used to determine the effect of lagged Disproportionate Share Hospital (DSH) status on next year patient experience ratings. The Hospital Consumer Assessment of Healthcare Providers and Systems data provide publicly available patient ratings. Results On average, hospital ratings increase by 6% as a result of DSH status. Hospital ratings increase by an average of 6.5% when nonprofit hospitals are analyzed. This finding is primarily driven by patient facility cleanliness and medical provider communication ratings. Conclusions The federal mandate that individuals purchase health insurance in the United States coupled with the state expansion of Medicaid coverage will theoretically eliminate the need for Medicare DSH payments. It is calculated, however, that hospitals will need increased Medicaid reimbursements of more than $300 per patient to make up for the loss of Medicare DSH reimbursements. Hospitals will likely suffer financially as a direct result of reduced Medicare reimbursements through the DSH program.
One of the conditions for the successful functioning of transport companies is that the latter should maintain and increase certain levels of competitiveness. Most small transport companies should ...try to find their own market niche for protecting themselves from competition. To this effect, the providers of such services should seek to offer are unique and different from competitors’ services. This paper tries to give an answer the question as to what has the greatest impact on consumers when deciding on the choice of the carrier. The proposed solutions will help transport companies in the formulation and development of competitive strategies. The analysis was carried out on the basis of the results of a questionnaire study conducted in Bulgaria, examining the degree of satisfaction of users of transport services
Aim
This article describes the Clinical Nurse Leader role in implementing person‐centred care bundles to improve patient outcomes through an innovative culture of caring.
Background
Demonstrating the ...financial value of introducing the Clinical Nurse Leader role into an organisation is essential for sustainability. Previous authors have established the Clinical Nurse Leaders' influence on patient satisfaction and have suggested that Clinical Nurse Leaders improve the continuity of care after discharge.
Evaluation
Descriptive data are shared to illustrate the effectiveness of implementing the patient care bundles and a Clinical Nurse Leader‐driven discharge phone call process.
Key issues
Clinical Nurse Leaders who practise from a caring lens are uniquely situated to lead initiatives that drive person‐centred care with the goal of reducing readmission rates. Patients who receive person‐centred care have an improved perception of the hospital experience and are more likely to return to the facility.
Conclusions
Clinical Nurse Leaders establish relationships with patients that increase the likelihood of successful outcomes from the discharge phone call process. Further evaluation of the Clinical Nurse Leader's role and potential impact on patient outcomes is warranted.
Implications for nursing management
Clinical Nurse Leaders are uniquely prepared to lead transformational change within an organisation. Clinical Nurse Leader interventions that are developed at the microsystem level in response to problems may have system‐wide implications.
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