Drivers of Inpatient Hospital Experience Using the HCAHPS Survey in a Canadian Setting

ObjectiveTo identify factors associated with patients’ overall rating of inpatient hospital care.ConclusionsOur results are novel in the Canadian population. Several questions for future research have been generated, in addition to opportunities for quality improvement within our own organization.     

The ‘Hyperactive’ Child

A new, more apt designation, attentional deficit disorder (ADD), may help dispel some of the myths that have surrounded the “hyperactive” child. An abnormally high level of physical activity is a common but not universal finding in these children but is not their central problem. In most affected children, early diagnosis and specific drug treatment can ward off the often disastrous psychiatric and social consequences of ADD.     

Nexus: Physician-Assisted Suicide and Health Services Delivery

Two major factors trouble hospital engineering departments today. First, engineers are saddled with a janitor's image, a misconception contradicting the job's rapidly advancing sophistication and formidable academic requirements. Second, a staggering rate of technological advancement complicated by the introduction of energy conservation mandates has been thrust upon the engineer.

Until the mid-1960's, acquisition cost was the only consideration in equipment selection. Given proportionately low energy prices, long term payback considerations and efficiency were of the lowest priority in purchasing deliberations.

System integration was a virtually unknown concept. Today, energy efficiency is a prime concern in the selection of many pieces of equipment. The hospital engineer is looked to for that input.     

Are HCAHPS Scores Higher for Private vs Double-Occupancy Inpatient Rooms in Total Joint Arthroplasty Patients?

Background

Private hospital rooms have a number of potential advantages compared to shared rooms, including reduced noise and increased control over the hospital environment. However, the association of room type with patient experience metrics in total joint arthroplasty (TJA) patients is currently unclear.

The association between the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey and real-world clinical outcomes in lumbar spine surgery

Background Context

The patient experience of care as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey is currently used to determine hospital reimbursement. The current literature inconsistently demonstrates an association between patient satisfaction and surgical outcomes.

What Factors Drive Inpatient Satisfaction After Knee Arthroplasty?

Background

The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, developed by the Centers for Medicare & Medicaid Services, is directly tied to hospital reimbursement. The purpose of this study is to analyze survey responses from patients who underwent primary knee arthroplasty in order to identify factors that drive patient dissatisfaction in the inpatient setting.

Press Ganey Administration of Hospital Consumer Assessment of Healthcare Providers and Systems Survey Result in a Biased Responder Sample for Hip and Knee Arthroplasties

BackgroundPress Ganey administration of Hospital Consumer Assessment of Healthcare Providers and Systems Survey after discharge is sometimes used to monitor hospital performance and adjust reimbursements. Hypothesis: significant differences exist between responders and nonresponders. We assessed baseline characteristic differences between responders and nonresponders; sampling bias; responding predictability in total joint arthroplasty patients; and differences in sampling and response rates among different hospitals.MethodsA prospective database of arthroplasty patients from January 1, 2016 to September 30, 2016 was used to compare responders’ and nonresponders’ baseline characteristics at 4 hospitals. A univariate analysis between groups was performed. A multiple logistic regression model was used to assess whether Press Ganey sampling was predictable. We identified receiving and responding predictors.ResultsWe captured 96.6% (3255 of 3369) of hip and knee arthroplasties. Hospital Consumer Assessment of Healthcare Providers and Systems Survey sampling rate was 60% and response rate was 36% (1157). Responders were more likely Caucasians, nonsmokers, discharged home, have shorter hospital stays, have higher baseline joint pain and physical composite scores, and have better mental health composite scores. Concordance indices suggest reasonable-to-very-strong model predictability for those sampled (range 0.56-0.91) and those responding (range 0.61-0.78). Completion predictors were Caucasian race (P < .0001), younger ages (P < .0001), discharged home (P < .0001), negative smoking status (P = .02), quit smoking (P = .0026), higher baseline mental health composite scores (P = .0096), and diagnoses of femoroacetabular impingement (P = .0056), osteoarthritis (P = .0111), or prosthesis failure (P = .0036).ConclusionResponders/nonresponders were significantly different in several characteristics. It can be predicted who will likely be sampled and who will complete. Responders were not representative of arthroplasty population. Research is needed for more representative sampling methods.Level of EvidenceLevel III.     

Emergency department visits after lumbar spine surgery are associated with lower Hospital Consumer Assessment of Healthcare Providers and Systems scores

Background

Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys are used to assess the quality of the patient experience following an inpatient stay. Hospital Consumer Assessment of Healthcare Providers and Systems scores are used to determine reimbursement for hospital systems and incentivize spine surgeons nationwide. There are conflicting data detailing whether early readmission or other postdischarge complications are associated with patient responses on the HCAHPS survey. Currently, the association between postdischarge emergency department (ED) visits and HCAHPS scores following lumbar spine surgery is unknown.