Patient experience and quality of urologic cancer surgery in US hospitals

“…Participants rate the frequency of experiencing each of the following: difficulty understanding the doctor because of an accent or way English was spoken; not understanding medical words; doctor speaking too fast; doctor using different aids when explaining things; doctor ignoring information provided; being interrupted by the doctor when talking; doctor showing interest in questions and concerns; satisfaction with answers provided to questions; and being encouraged to ask questions or discuss concerns. The CAHPS health literacy questions are a validated measure for consumers to provide feedback on their experiences of communication with providers (Lake et al 2005;Horowitz et al 2012;Agency for Healthcare Research and Quality 2016;Shirk et al 2016;Thiels et al 2016). The BHLS questions and the CAHPS questions have not been validated for their use with Aboriginal and Torres Strait Islander people.…”

Section: Data Collection and Recruitmentmentioning

confidence: 99%

Understanding health talk in an urban Aboriginal and Torres Strait Islander primary healthcare service: a cross-sectional study

Lakhan

Askew

Harris

et al. 2017

Aust. J. Prim. Health

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Abstract. Health literacy is an important determinant of health status. This cross-sectional study aimed to describe the prevalence of adequate health literacy among Aboriginal and Torres Strait Islander patients or their carers including parents of sick children attending an urban primary healthcare clinic in Australia, and their experiences of communication with General Practitioners (GPs). A questionnaire, including questions from the Brief Health Literacy Screen (BHLS) and questions from the Consumer Assessment of Healthcare Providers and Systems (CAHPS): Communication with Provider, was administered to 427 participants. Descriptive statistics, Pearson's Chi-Square test and logistic regression analysis were used to describe the prevalence and risk factors associated with health literacy and any associations between the CAHPS questions and health literacy. In total, 72% of participants had adequate health literacy. An age of 50 years was independently associated with inadequate health literacy, and completion of secondary or post-secondary schooling was protective. Communication questions that identified areas for improvement included less use of incomprehensible medical words and more frequent use of visual aids. The study provides useful information on health literacy among Aboriginal and Torres Strait Islander patients, or their carers, and their experiences of communication with GPs. Further populationbased research is required to investigate the effect of health literacy on health outcomes of Aboriginal and Torres Strait Islander patients.

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“…3 The findings of their study indicate that some of the HCAHPS measures for patient satisfaction are modestly associated with a prolonged length of stay and nursingsensitive complications at high-performing hospitals compared with low-performing hospitals. For example, patient communication with nurses and physicians, discharge information, and explanation of medications were found to be associated with a lower risk of prolonged hospitalization.…”

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confidence: 96%

“…1 Second, several studies have consistently shown that larger hospitals have higher HCAHPS scores across different surgical procedures, which is likely attributable to the availability of a greater number of providers, nurses, and resources. 2,3,5 Conversely, the use of such patientreported outcome measures and linking them to financial incentives and penalties may expose hospitals with limited resources to greater financial risk. In particular, safety-net hospitals, which provide a greater percentage of medical care to vulnerable patient populations, have been shown to have lower HCAHPS scores.…”

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confidence: 99%

Improving the patient experience in the delivery of high quality surgical care and health outcomes

Kim

Abouassaly

2016

Cancer

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With passage of the Patient Protection and Affordable Care Act, the Centers for Medicare and Medicaid Services (CMS) has placed a greater degree of emphasis on value for health care delivery by focusing on improving health outcomes and quality and lowering costs. A key health care policy initiative that embodies this development involves the CMS Hospital Valued-Based Purchasing Program, which has begun to financially incentivize the delivery of high-quality and patientcentered health care. Along with other key clinical outcomes measures, such as complications and 30-day mortality, patient experience has been considered to be an essential component in determining high-value health care.In 2002, the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Survey was developed as a method with which to measure the patient experience during hospitalization. The project had 3 main goals: 1) to produce data that would allow objective comparisons of hospitals regarding topics that are important to patients; 2) to create incentives for hospitals to improve quality of care through the public reporting of HCAHPS results; and 3) to increase the accountability in health care and transparency of the quality of the hospital care provided. Since July 2007, many hospitals have been required to collect and submit HCAHPS data to receive full payment, and the public reporting of results began in March 2008. The 32-question HCAHPS survey encompasses 9 key domains: 1) communication with physicians; 2) communication with nurses; 3) responsiveness of hospital staff; 4) pain management; 5) communication about medicines; 6) discharge information; 7) cleanliness of the hospital environment; 8) quietness of the hospital environment; and 9) transition of care. The survey is administered to a random sample of adult inpatients between 48 hours and 6 weeks after discharge.Although patient-centered care is essential to improving health outcomes, use of the patient experience in determining health care value and quality has been considered controversial to some degree. The validity in using surveys to critically evaluate a patient's hospitalization experience, such as HCAHPS, is predicated on reliably evaluating for health care quality and outcomes. However, the degree to which these surveys accurately capture and include domains sensitive enough to correlate with the other commonly used outcome measures, such as length of stay, postoperative complications, and patient safety, and that are applicable across different surgeries are mixed. Some studies have suggested that higher patient satisfaction is modestly associated with a shorter length of stay, higher surgical volume, and receipt of care at larger hospitals. 1,2 In this issue, Shirk et al examined the relation between the patient-centered experience and hospital outcomes for patients undergoing radical prostatectomy, nephrectomy, and cystectomy for genitourinary malignancies by linking the Nationwide Inpatient Sample (NIS) and hospital-level HCAHPS scores.3 The findings o...

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Patient experience and quality of urologic cancer surgery in US hospitals

Cited by 27 publications

References 28 publications

Malnutrition Diagnosis during Adult Inpatient Hospitalizations: Analysis of a Multi-Institutional Collaborative Database of Academic Medical Centers

Malnutrition Diagnosis during Adult Inpatient Hospitalizations: Analysis of a Multi-Institutional Collaborative Database of Academic Medical Centers

Understanding health talk in an urban Aboriginal and Torres Strait Islander primary healthcare service: a cross-sectional study

Improving the patient experience in the delivery of high quality surgical care and health outcomes

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