Background: The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey provides a standardized methodology to measure patients’ perspectives on hospital care. HCAHPS performance is also tied to the incentive payment calculation of the value-based purchasing program, which has a tremendous financial impact on the hospitals. A review of the monthly HCAHPS survey results at two medicine units indicated that the scores on nursing communication, medication communication, and staff responsiveness domains have been below the threshold for more than 3 months. The nursing staff’s inconsistency in bedside practice was identified by unit management and charge nurses. Hence, the patient experience training program was created by two clinical nurse educators to enhance the quality of patient care.
Purpose: The aim of this quality improvement project was to evaluate whether a 2-hour educational intervention presented to the nursing staff of two medicine units would improve their knowledge of the HCAHPS survey and the unit’s HCAHPS performance.
Method: The face-to-face educational training, facilitated by two clinical nurse educators, consisted of the following topics: HCAHPS overview, survey questions, scoring, best practices, and hospital initiatives. The training also had a special focus on nursing communication, medication communication, and staff responsiveness domains. A guest speaker from guest relations department was invited to join part in the training. The nurse educators used various teaching methods such as lecturing, storytelling, games, teach-back method, and group discussion to deliver the contents. For the training evaluation, the participants were invited to complete the “minute paper,” in which they were asked to identify significant topics they have learned from the training session and provide suggestions for improving HCAHPS scores. There were 4 training sessions offered to the staff within 6 months. This training content was later incorporated into the core of the standard patient satisfaction training for other units. The HCAHPS scores were monitored by the nurse educators and shared with staff during monthly shared governance meetings.
Results: A total of 94 participants attended the in-person patient experience training. The units’ HCAHPS overall scores went up to 100% in the following month after the initial training. Both medication communication and nursing communication domains have improved significantly following the training. In regards to the staff responsiveness domain, the scores have made improvements; however, we have identified barriers to achieving the target. Data from the post-training survey revealed that the topics most frequently cited by the participants were not knowing HCAHPS questions and scores, learning “consistency” is the key, using keywords, and hospital initiatives such as iPad use for patients. The most common themes cited by the participants to improve HCAHPS scores were teamwork and communication.
Conclusion: Findings from this project suggest that educational intervention consisting of various creative teaching methods increased bedside nurses’ knowledge of the HCAHPS survey and unit performance.
Evidence-based references
1. Briggs, K., Sharma, L., Chandrasekaran,A., Douglas, C., Aroh, D. & Finefrock, D. (2018). The effect of a hybrid training program: Improving nursing communication skills and HCAHPS scores. Nursing Management, February 2018; 49(2):51-53
2. Keith, JL, Doucette, JN, Zimbro, K., Woolwine, D. (2015). Making an impact: can a training program for leaders improve HCAHPS scores? Nursing Management. March 2015; 46(3):20-27.