Healthcare Leaders Applaud New HCAHPS Survey; NQF Releases First-Ever Nationally Standardized Patient Perception of Care Survey


WASHINGTON, D.C. -- A nationally standardized survey for measuring how patients perceive the care they receive in hospitals was made available today when the National Quality Forum (NQF) released a report conveying the first-ever such standardized survey and reporting instrument.

The survey, commonly known as Hospital CAHPS or HCAHPS, will tell hospital managers and caregivers, among others, what patients think of their hospital care.  Because HCAHPS is standardized, it will allow comparison of care between and among hospitals across the country.

Hospital surveys of patients' perception of care have been used for many years, but these surveys have been developed by many different entities; because they have not been standardized, they did not provide publicly available, comparable information that could be used by consumers.  The consensus-based, new HCAHPS survey changes this by presenting a single, standardized method for collecting and scoring this information, which will be publicly reported.

Healthcare leaders from a wide variety of constituencies welcomed publication of NQF's Standardizing a Measure of Patient Perspectives of Hospital Care, which presents the HCAHPS survey along with instructions for its administration.

"HCAHPS will improve the quality of care in American hospitals by ensuring

that the patient's voice is heard and understood," said Kenneth W. Kizer, MD, MPH, president and CEO of NQF.  "In order to understand what patients think of their hospital care, we have to ask them about it.  However, to get reliable and comparable information, the questions need to be the same and they need to be asked in the same way -- that is, we need to have a standardized approach to asking patients what they think of their care."

The primary purpose of the NQF-endorsed survey instrument is to provide standardized information across institutions and over time about how patients perceived their hospital care.  HCAHPS is a 27-item survey developed by the Centers for Medicare and Medicaid Services (CMS) and the Agency for Healthcare Research and Quality.  It was approved with the consensus of NQF's nearly 300 member organizations, which include consumer groups, professional associations, provider groups, purchasers, federal agencies, and research and quality improvement organizations, through NQF's formal Consensus Development Process.

"Healthcare consumers have for years been demanding better information about direct patient experience in hospitals," said Gerald M. Shea, assistant to the president for government affairs at the AFL-CIO, a member of the Hospital Quality Alliance, and co-chair of the NQF's Standardizing a Measure of Patient Experience with Hospital Care HCAHPS Review Committee, which discussed the patient survey at length.  "This kind of information is the Holy Grail in our search for relevant, actionable information for consumers."

The survey asks patients about their experiences in seven areas of hospital care through 22 questions addressing: communication with doctors, communication with nurses, responsiveness of hospital staff, pain control, communication about medicines, cleanliness and quiet of the environment, and discharge information.  It also includes five demographic questions (used for patient-mix adjustment and other analytic purposes).  To ensure that results are comparable across hospitals, the survey also comes with standard specifications include sampling; survey administration; and how the results are calculated and reported.

Consumer advocates and healthcare provider organizations alike agreed that information gleaned from HCAHPS will improve the quality of healthcare delivered in U.S. hospitals.

"For hospitals, an important step in improving care is understanding what patients think about the care they've received in the hospital," said American Hospital Association president Dick Davidson.  "HCAHPS is a way to compare -- apples to apples -- patients' satisfaction with their care and that can tell us a lot about how to improve care in our hospitals.  AHA is fully supportive of the HCAHPS questionnaire and hospitals are committed to sharing this valuable information on the care they provide with their patients and communities."

"Investor-owned hospitals believe that competition plays a valuable role in improving healthcare, and that well-informed consumers make better personal care choices," said Charles Kahn, president of the Federation of American Hospitals.  "We strongly support HCAHPS as part of Hospital Compare because it will increase the amount of useful information available to help consumers better evaluate their community hospitals."

    The process by which HCAHPS was vetted includes multiple stakeholder input, review, voting, and a public appeals process, conferring special legal standing as a voluntary consensus standard.  The executive summary of the report, along with the survey and instructions for its use, can be found on the NQF Web site at:  Results from this NQF-endorsed standard are intended for public reporting, and the Hospital Quality Alliance intends to make HCAHPS scores available for public viewing on CMS's "Hospital Compare" Web site (

Source: National Quality Forum

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