Patient satisfaction surveys are a major component of the rating system on CMS’ Home Health Compare website. Considering that patients and families use this rating system to weigh their options for Medicare-certified home health agencies, improving responses on these patient surveys should be a top goal of every agency.
Plus, happier clients are good for business.
Fortunately, there are straightforward steps agencies can take to ensure that not only are their clients thrilled with the care they receive, they’re also more than willing to write glowing responses on their satisfaction survey.
But first, let’s dig into how patient surveys influence agency ratings on the Home Health Compare website.
Home Health Compare and the HHCAHPS Survey
The Home Health Compare website rates agencies on a five-star scale across care delivery, care outcomes, and the general patient experience. Ratings are objective and based on quantitative data compiled by CMS.
Data measuring the patient experience of care comes from the Home Health Consumer Assessment of Healthcare Providers and Systems (HHCAHPS) Survey. The 34 questions on the survey cover topics such as:
- How often did the patient’s health team provide care in a professional way? Were there problems with the team? Were providers gentle and respectful? Were providers up to date with the patient’s care plan?
- How well did the agency team communicate with the patient? Were all services explained clearly? Did the patient know when staff would arrive? Did the caregivers listen carefully?
- Did the team discuss medicines, pain, and home safety with the patient? Did anyone talk with the patient about the prescription medicines the patient is taking, including dosages, timing, and possible side effects? Did anyone talk with the patient about how to set up the home to move around in safely?
- How does the patient rate the overall care from the agency, on a scale of 0 to 10? Zero represents the worst care possible, and 10 represents the best care possible.
- Would the patient recommend the agency to friends and family?
Clearly, simply delivering outstanding care isn’t enough for a high rating. Patients must be happy with their experiences as well. Incorporating the following low-tech, high-impact practices can set the stage for a better patient experience and higher satisfaction scores:
Tip #1: Create a Top-Down Patient-Centered Culture
A 2015 study by Johns Hopkins of patient satisfaction around hospital care looked at how hospitals that perform well with patient satisfaction surveys function differently than hospitals with low satisfaction scores. It turns out that a key driver of patient satisfaction occurs when leadership teams and medical staff members collectively share a high priority on the needs of patients and their families.
“It may seem a simple thing,” states lead study author Hanan Aboumatar, M.D., M.P.H. “But if leaders and staff members don’t prioritize this commitment and link it to the greater mission, it becomes easier to lose sight of it in the hectic pace of hospital care.”
This is an important lesson for the home care industry as well. Patient-centered care starts at the top of the organization; if agency leaders want their caregivers to be more mindful of the needs of the patient, the leadership team must create the environment to make it happen.
Tip #2: Understand That Little Things Are Big
In an age where daily life is increasingly digitized, sometimes the simplest things can have the biggest impact.
In home care, “simple” can mean such practices as reminding caregivers to always make eye contact with patients, to take the time to listen carefully to patients, or to sit at the patient’s level (especially if the patient is bed-ridden) rather than standing or hovering over the patient.
In other words, the caregiver’s role is not just about function; it’s also about purpose. Function describes the “what” of the job: setting reminders for medications, helping the patient go for a walk, making the patient a meal. Purpose, on the other hand, is so much bigger. Purpose involves remembering that patients are people too – people who may feel vulnerable or overwhelmed and desperately want to be treated with dignity and respect.
Tip #3: Know What Makes Patients Upset
Home Care Pulse, which conducts satisfaction research for the home health industry, recently released a list of the top 10 patient complaints they encounter. While not every complaint is easily resolved – or even within the ability of the agency to resolve – understanding these hot-button issues can help agencies avoid them:
- Confusion in communication across caregivers
- Lack of caregiver punctuality
- Inconsistent quality of care
- Caregivers on their phones during visits
- Lack of caregiver training for expected tasks
- Cultural differences and language barriers
- Lack of discounts for longer shifts
- Inflexible pay schedule
- Being charged time and a half on holidays
- Not being informed if a caregiver calls in sick
Many of these complaints can be averted with the right Care Delivery Management solution. Home care software that includes mobile apps for caregivers will facilitate communication between office staff and workers in the field and will ensure caregivers always have access to the most up-to-date schedules, care plans, and patient records.
For those issues that are out of the agency’s hands (such as overtime pay), it can help to be upfront with communication, so patients and families at least understand why a policy is in place.
Tip #4: Teach All Staff How to Respond to a Complaint
Few things escalate a bad situation faster than a service provider who treats a complaint with disdain.
In his excellent Forbes article, Micah Solomon reminds readers that resolving patient issues means getting rid of defensiveness and, instead, knowing how to apologize when confronted by a patient or family member upset with what they perceive to be a service gaffe.
“Take your patient’s side in these situations,” he states, “Immediately and with empathy, regardless of what you think the ‘rational’ allocation of ‘blame’ should be.”
Sometimes, the right approach is as simple as listening to the complaint, paraphrasing it back to the patient or family member to ensure the staff member understands the situation, and empathizing. Statements like “No wonder you’re upset!” or “I’m so sorry that happened” can go a long way to diffuse the moment and put the patient or family member at ease.
Solomon suggests role-playing exercises with staff, so they can internalize this mindset and work together to build a blame-free environment.
Tip #5: Know What NOT to Do
Given the importance of the HHCAHPS Survey, some agencies may be tempted to sway their patients into providing positive responses. They should be careful to resist that urge, however.
The HHCAHPS guidance is quite clear on the need to keep surveys unbiased. Specifically, CMS states that agencies may not:
- Attempt to influence the patient, family, or caregivers to respond in any manner
- Ask for a specific score for any HHCAHPS question
- Indicate to a patient that it is the agency’s goal to achieve a certain score
- Imply there is any reward for the agency or staff based on attaining a certain score
- Offer any incentives to patients for responding to the survey
Agencies may inform patients they may receive a survey, but they may not single out patients when doing so; agencies must instead incorporate this into their communications with all patients.
Fortunately, the good news is that a solid, comprehensive approach to patient communication, employee engagement, and caregiver training should be enough to yield top-grade survey results. And the best news of all is that these steps can be implemented anywhere – no expensive resources required. All it takes is genuine commitment and a good dose of common sense.
For more insights into leveraging data to improve agency performance, download our white paper, “Measure what matters for successful home care management” today.