Improving HCAHPS Scores in Montrose Memorial Hospital

Answer

Improving HCAHPS Scores in Montrose Memorial Hospital

All hospitals in the US are required by the Centers for Medicare and Medicaid Services (CMS) to conduct patient satisfaction survey known as the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). According to Mann et al. (2016), the aim of the HCAHPS is to get the voice of patients and hence, form the basis for future improvements. Additionally, the HCAHPs scores are used by the government in reimbursing hospitals based on their performance, hence keeping them financially strong (Davidson et al., 2017). This report provides an analysis of HCAHPS scores in Montrose Memorial Hospital (MMH); an acute care hospital in Colorado county. Additionally, a strategic plan for improvement of the hospital’s HCAHP scores will be provided.

1. HCAHPS Scores

Based on the patient survey summary star rating, MMH had a 4-star rating. 79 percent of the patients reported that their nurses and patients always communicated well and stated that they would definitely recommend the hospital. However, only 74 percent of patients reported that they always received help promptly while 73 percent admitted to being explained medicines before receiving them (Medicare.gov, 2018). 66 percent of the patients reported that their room was always quiet at night with only 53 percent agreeing that they “strongly agree” that they understood their care when they left the hospital.

B1. State and National Averages

            Compared to the state and national averages, MMH’s HCAHPS scores are relatively good. In terms of the patients reporting that the nurses and doctors always communicated well, the hospital scored 79 percent compared to 80 percent and 82 percent of the state and national averages respectively (Medicare.gov, 2018). However, the 74 percent score of the patients reporting that they always received help promptly is higher compared to the state average of 72 percent and a national average of 70 percent. 79 percent of the patients from the hospital who reported “YES” that they would definitely recommend the hospital is higher compared to 76 percent state and 72 percent national averages.

B2. Comparison with Other Hospitals

            When compared to other hospitals in the region, MMH performed relatively poorer despite the other two hospitals also having 4-star ratings. However, the 79 percent that the hospital scored on the nurses and doctors always communicating well is lower than that of Gunnison Valley Hospital (88 percent) and Heart of The Rockies Regional Medical Center (85 percent) (Medicare.gov, 2018). Additionally, in a majority of other areas of the HCAHPS, MMH scored relatively poorer than other two hospitals in the region.

B3. Survey Response Rates

            The response rate in MMH is relatively lower compared to other hospitals. In specific, whereas the response rate for the various areas of the survey was 27 percent in the case of Montrose Memorial Hospital, the response rate in Gunnison Valley Hospital was 32 percent, whereas that in Heart of the Rockies Regional Medical Center was higher at 34 percent (Medicare.gov, 2018).

B4. Demographics and Services Provided

The patient population demographics in MMH include both children and adults as well as the elderly. It serves male and female patients with varied health conditions. The services provided by the acute care hospital are emergency. MMH provides services in more than 20 specialties including joint replacement, complete cancer care, cardiology, and rehabilitation among others (Montrose Memorial Hospital, 2018).

B5a. Cultural Dynamics

The community factor of cultural dynamic affects the communication between the nurses and the doctors. Notably, in Colorado, English and Spanish are the most spoken languages. However, the native American languages of Navajo and Swedish are also spoken. As such, there might be a language barrier between the patients and the nurses and doctors which can negatively influence the communication between them and hence the HCAHPS scores (Betancourt et al., 2016).

B5b. Educational Dynamics

According to Herrin, Mockaitis, and Hines (2018), patients with poor education will have low satisfaction levels as there will be a lack of understanding between the patients and the healthcare providers (nurses and doctors). As such, poor education on the part of the patients will result in low HCAHPS scores while patients will quality education will have high levels of satisfaction and hence higher HCAHPS scores (Manary et al., 2015).

B5c. Socioeconomic Dynamics

            Patients with differing socioeconomic dynamics have varied levels of priorities. As such, the socioeconomic statuses of the patients will dictate their level of satisfaction and the HCAHPS scores (Mann et al., 2016). Patients with low socioeconomic statuses have lower priorities and hence, likely to be satisfied resulting in high HCAHPS scores while those with high socioeconomic statuses have higher expectations and hence low levels of satisfaction and eventually lower HCAHPS scores.

B6. Financial Impact

            The relatively low HCAHPS scores of MMH will result in lower reimbursements from the CMS and thus short and long-term financial stability of the organization. Additionally, according to Mann et al. (2016), in the long term, the organization will fail to attract more clients due to the low HCAHPS scores as patients will be keen to visits hospitals with high scores which would lower the financial resources of the healthcare facility.

B6a. Impact on Quality

The decrease in financial resources over the long-term would have adverse effects on quality outcomes. Notably, MMH requires financial resources to ensure recruit members of staff and provide quality care. However, according to Davidson et al. (2017), with decreased financial resources, the necessary resources required for the provision of quality care will not be available, which would then adversely affect the quality outcomes of care.

1. Cause of Scores

The HCAHPS scores of MMH can be attributed to various probable causes. One of the potential causes is poor communication skills on the part of the nurses and doctors. Additionally, the absence of proper leadership which provides patients with information and increased understanding of the meaning of care is a potential cause of the HCAHP scores (Herrin, Mockaitis & Hines, 2018). Finally, failure by the MMH’s administration to focus on the specific drivers of satisfaction is a potential cause of the low HCAHPS scores.

D1. Organizational Change

MMH can make various organizational changes to improve its HCAHPS scores. One of the changes is provision of training to patients on how they can communicate properly and effectively (Keith et al., 2015). Additionally, they should start a program for the provision of adequate education to patients on the concepts of care and medications (Mann et al., 2016). Changes should be made on the specific drivers of satisfaction which should be targeted in the improvement of HCAHPS scores.

D2. Structure, Process, And Outcomes

The strategic plan for the improvement of MMH’s HCAHPS scores will be structured around the Deming’s model of plan-do-study-act (PDSA). The process will involve identifying specific patient satisfaction areas which require improvement and preparing a plan on how to improve them (Peterson et al., 214). The second step will be implementing the plan by taking small steps. The outcomes of the implementation will then be studied and actions taken to now improve the process. The expected outcomes will be increased communication efficiency between patients and nurses and doctors, and generally increased HCAHP scores.

D3. Improving Organizational Quality

Evidence-based practices on the areas of increasing patient satisfaction will be used in the quest to improve organizational quality. Additionally, shared governance will be used to ensure that the core values and beliefs, as well as professional competencies in both nursing and medical practice, are followed. The principles of partnership, accountability, and provision of culturally sensitive care will be used in ensuring quality improvements in MMH which will ultimately improve HCAHPS scores.

D4. Shared Accountability

To ensure that there is shared accountability among patients, medical providers, payers, and the personnel, the views and opinions of each one of them will be sought. Additionally, the responsibilities of each of the parties will be stipulated so that each of the stakeholders can be accountable for their actions (Peterson et al., 2014). By using vertical integration, the stakeholders will recognize their distinct roles and hence minimize the risks through risk stratification.

D5. Technology Trends

One of the methods which will be used in the incorporation of technology in healthcare will be identification of the existing trends, especially in the areas of innovation in training and telemedicine. I will incorporate the trends by identifying the advanced training tools and using them in the provision of education to the personnel and patients. Additionally, the incorporation of telemedicine will be an important technological trend which will help in medical prescription.

D6. Improve Care Delivery System

            To improve the care delivery system, various methods will be used in MMH. One of those is an improvement of the quality of services provided in MMH by ensuring that the rooms used by the patients are cleaner and that services offered are of high quality and provided in a timely manner. To ensure reduced costs of care, a review of the areas where cost can be reduced will be done. Access to care will be ensured through the provision of different packages based on the socioeconomic statuses of the patients. Patient-centered care will be improved by hiring more personnel who will ensure that they identify the needs of each individual patients and the provision of health services based on their needs.

D7. Improve Financial Stability

To improve the financial stability of MMH, one of the methods which will be used will be increased patient satisfaction which will then translate to higher disbursements from CMS. The disbursements will improve the financial stability of the hospital. However, providing quality services will attract more clients which will boost the financial base of MMH and hence ensure its financial stability in the long term.

E1. Key Roles and Responsibilities of Stakeholders

The key stakeholders in the implementation of the strategic plan for the improvement of the HCAHPS score will be the hospital personnel, patients, and the insurance providers. The personnel in the facility will have the role of providing the necessary financial and human resources for implementation. Additionally, the staff members will take a key role in ensuring that the implementation follows the expected pathways and achieves the expected goals. The patients will have the role of cooperating and providing their views about the implementation process. The insurance providers will play a pivotal role in evaluating the success of the strategic plan in terms of the achievement of the key goals of HCAHPS improvements.

D2. Stakeholder Accountability and Involvement

To ensure stakeholder accountability, each of the key stakeholders will be monitored as to whether they have undertaken their roles in the manner planned. However, stakeholder involvement will be ensured via consultations. In specific, each of the key stakeholders will be consulted as to their views and opinions about the process of implementation and the role that they can play to ensure that the plan becomes a success.

D3. Training Staff

In order for the personnel/members of staff to implement the strategic plan, they will be trained on the areas that they need to improve on and what their roles are in the strategic plan (Keith et al., 2015). Training will also be done on aspects of effective communication which is a key aspect of patient satisfaction as well as the specific patient satisfaction drivers that they should focus on.

D4. Plan Implementation

1. Evaluate the Success of The Strategic Plan

The evaluation of the success of the plan will be done via various methods. One of those will be the use of key performance indicators (KPIs). In specific, according to Lynch (2015), the rates of patient satisfaction and HCAHPS scores can be used to measure the success of the plan. The evaluation of the timeline will be done by establishing whether the milestones have been achieved in the manner provided in the timeline. The method of analysis that will be used will be performance analysis, which will compare the original goals and objectives of the project against the actual outcomes (Todorović et al., 2015).

F1. Involvement of Key Stakeholders

In the evaluation, key stakeholders will be involved by asking them to send their representatives during assessments. For instance, the staff will have their representatives in the evaluation process whereas patients will be involved in a survey used to establish whether their levels of satisfaction have improved (Lynch, 2015). As for the insurance providers, their representatives will be involved in the evaluation so that they ascertain whether the goals of the strategic plan have been achieved and hence higher reimbursements.

F2. Communication of Results

The communication of the results of the strategic plan internally will be done through active and passive methods. In specific, face-to-face meetings will be held with the staff members and the results communicated. Additionally, passive methods will be used such as the printing of posters and brochures which will provide an analysis and report of the results (Sarstedt & Mooi, 2019). Externally, the results will be communicated by printing a report which will be published in the Hospital’s website.

In conclusion, HCAHPS scores are vital in getting the voice of patients hence, forming the basis for future improvements as well as being used by the government in reimbursing the hospitals based on their performance thus keeping them financially strong. MMH’s HCAHPS scores are relatively lower compared to those of other hospitals in the area. To improve the scores, a strategic plan should be implemented which will aim at ensuring effective communication among patients, nurses and doctors. Using Deming’s model of plan-do-study-act (PDSA), the areas which need improvement will be established and methods to improve them designed. The success of the plan will be done by assessing the KPIs of patient satisfaction. The results of the strategic plan will be communicated internally through face-to-face meetings while externally, communication will be done through printing a report and posting it in the Hospital’s website.