Better communication key to improving HCAHPS scores

Discharge and medication communication have room to grow

Hospitals nationwide can come away from the report with one key imperative: improve your communication strategies around discharge and medication. These are key opportunities to improve patient activation and engagement, experts agree, and are also predictors of patient safety.

Nearly every region had subpar scores in communication about medications and discharge plans. Moreover, the researchers flagged poor marks in the care transition process, a notable finding considering the key role discharge communication and medication education play in care transitions.

"Discharge and medication communication likely work better when hospitals employ strategies to enhance healthcare professionals’ communication skills, empower patients, and adopt discharge and communication practices that impact patient satisfaction," the researchers advised. "For example, incorporating a pharmacist and a discharge coordinator into medication communication and discharge planning can increase satisfaction scores and reduce readmissions."

Interestingly, the researchers found that hospitals in nearly every region performed well in the nurse and doctor communication sections of the HCAHPS surveys, despite poor marks in medication and discharge planning.

"The discrepancy between the ratings for communication with health professionals and information about medication and discharge planning is concerning but suggests opportunities for improving patient outcomes," the team explained.

These findings might follow nationwide trends in staffing and clinician workforce shortages.

"The data on staff responsiveness, medication communication, and care transition, including hospital discharge, underscore the pressing need to address issues such as understaffing and inadequate training across all regions," the team stated. "Prioritizing these areas will significantly enhance overall patient experiences and outcomes. Despite the inherent challenges, addressing these disparities is not just crucial -- it is imperative for the future of national healthcare."

The researchers also flagged cleanliness as a potential area for improvement, a vexing finding considering the fact that hospital cleanliness is often assumed.

While some states, like Oregon and South Dakota, received high HCAHPS scores for hospital cleanliness, others trailed far behind. The researchers acknowledged that the COVID-19 pandemic may have drawn increased attention to hospital cleanliness and hygiene practices, but stressed the importance of standardized protocols to promote patient safety.

Regional HCAHPS score variation could indicate areas of study

Importantly, the standardized HCAHPS survey creates opportunities to make apples-to-apples comparisons across the country, the researchers said. This is important as healthcare experts look to better understand how to improve the patient experience. Regions scoring poorly in one area can learn from hospitals in regions that did score well.

The Midwest had the best overall performance of any of the regions explored in the study, with higher scores for nearly every section of the HCAHPS survey, including cleanliness (86.27), nurse communication (91.47) and overall hospital rating (88.18). In contrast, the Other region scored the lowest across most relevant indicators.

"Differences in healthcare infrastructure, cultural values, patient expectations, economic conditions, and state policies are possible reasons why the Midwest scored better," the researchers posited, although the study did not investigate why HCAHPS scored scores differed by location.

Still, that's a good launching pad for new areas of patient satisfaction research, the authors added.

Take, for example, variation in communication and discharge planning. Vermont was the top-performing state for these metrics, which could be a good avenue for investigation as healthcare experts work to improve the patient experience.

Similarly, exploring the disparities in quietness ratings could be beneficial, as quietness is an indicator of overall patient comfort. States like Iowa, South Dakota and Wyoming got higher quietness scores than states like California, Connecticut, Massachusetts, New York and Oregon.

While differences in quietness scores could be due to rurality and the potential for hospital overcrowding in more populous states, the researchers said a better look at hospital operations would still be beneficial.

Closing the gap across the numerous patient satisfaction disparities identified in the analysis will require concerted efforts across the country, the researchers stated.

"A coordinated approach, which aligns local healthcare policies, hospital management strategies, infrastructure investments, and staff training with national standards, might mitigate existing disparities in patient outcomes and satisfaction," they concluded.

Sara Heath has reported news related to patient engagement and health equity since 2015.