At first glance, it might seem that the glory days of patient experience measurement occurred a decade ago, when surveying patients often meant sending them a page of home-spun questions, hoping for a handful of responses, and tackling the obvious service issues when time allowed. A laissez faire approach, maybe, but simple!
Today, simple is perhaps not the first word one would choose to qualify patient experience measurement, which, with the growing influence of value-based purchasing, often entails instrument selection from among an array of complex, overlapping surveys; compliance considerations; vendor relationship management; dedicated internal roles; and weighty financial implications.
But one need not condemn what is complicated or inconvenient. In fact, approached correctly, participation in CAHPS initiatives can have a meaningful impact on revenue and your mission – whether explicit or otherwise – to deliver outstanding care and a positive patient experience. The process takes time, yes, but it begins with a single first step – selecting the right instrument(s).
To help you get started, the following presents an overview of the complications to selecting a CAHPS instrument, as well as how to address them. (For more ideas, click the link at the end of the article to download Avatar’s free CG-CAHPS Preparedness Guide, which presents an approach applying to CG-CAHPS and other CAHPS surveys.)
Selection Consideration 1: Multiple Obligations
There are a number of reasons why CAHPS survey selection is complicated. First, many healthcare organizations are obligated not only to meet CMS’ requirements for value-based purchasing, but also the patient survey requirements of numerous other third parties, whether for accreditation, federal and local designations, or other drivers.
- Step 1: Map out all measurement obligations and any competing or overlapping instrument specifications. Does it make sense to select the survey that meets the greatest number of high-priority demands? Yes, though a supplementary survey may be needed for competing requirements.
Selection Consideration 2: Multiple Instruments
In addition to the instrument requirements posed by CMS, PQRS, and others, some regulatory-driven surveys such as CG-CAHPS have multiple instrument versions addressing different timeframes or care settings. Based on the environment in which your patients are treated, your compliance requirements, and your plans for internal use of the survey data, you should be able to narrow down your version selection options to a manageable few.
- Step 2: Identify the salient characteristics of each instrument, including appropriate settings, stage in survey lifecycle (is it likely to be used in future pay-for-performance?), and alignment with your internal measurement drivers. Narrow down your list!
Selection Consideration 3: Performance Improvement
For all their complexity, CAHPS Surveys have already had a powerful impact on healthcare, but used alone they are typically not adequate tools for guiding performance improvement efforts. Proprietary, driver-focused patient experience surveys are ideal as a foundation for performance improvement. It is important to keep in mind that different programs have different guidelines as to whether and how supplemental survey items can be utilized.
- Step 3: Assess how the CAHPS instrument options you’ve identified will incorporate with your performance improvement efforts and supplemental surveying. If you’re already surveying patients, can the items be integrated with your CAHPS surveys? Do your existing surveys provide an adequate foundation for improving CAHPS scores over time? How will you establish and coordinate sampling and administration plans to meet your compliance and performance improvement needs?
These are just a few of the reasons why CAHPS survey selection can be challenging, as well as some steps for addressing the challenge. For many, the ultimate objective is to meet all compliance and performance improvement needs while minimizing redundancy and maximizing cost efficiency. While these recommended steps can serve as a starting point to achieving that objective, the path to an optimal, cost-effective program remains somewhat complex. When in doubt, grab your draft roadmap and pencil and call up a trusted expert. A good vendor will be happy to help you navigate your selection process.