The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey is “the first national, standardized, publically reported survey of patients’ perspectives of hospital care” (Studer, & Robinson, 2010).

The Centers for Medicare & Medicaid Services (CMS) explains that the HCAHPS survey was designed for three overarching goals:

  1. To produce comparable data on patients’ perspectives of care so that consumers can make objective and meaningful comparisons among hospitals.
  2. To create incentives for hospitals to improve their quality of care.
  3. To enhance public accountability in healthcare by increasing the transparency of the quality of hospital care.

The HCAHPS survey is a part of a value-based purchasing initiative that ties reimbursement to quality outcomes, as opposed to traditional fee for service reimbursement structures. The survey is broken into two sections. The first section measures frequency (the scale is never, sometimes, usually, or always) on six composites of questions and two additional questions in regards to:

  • Communication with doctors
  • Communication with nurses
  • Responsiveness of hospital staff
  • Pain management
  • Communication about medications
  • Cleanliness of hospital
  • Quietness at night of hospital

There is one more composite and three additional questions whose answers are in different formats:

  • Discharge information (no to yes)
  • Willingness to recommend (definitely no to definitely yes)
  • Overall hospital rating (0 to 10 rating scale)

The most frequently reported “best” result in each composite is reported for each hospital. “Always” is the only response that counts, and there is no partial credit for “almost.” This is to say that if 75% of hospital patients respond that their doctors “always” communicated well, while the other 25% of responses fell below the top box score, only 75% is reported in response to that question.

The questions that this project aims to improve are specific to hospital communication:

  • During this hospital stay, how often did nurses explain things in a way you could understand?
  • During this hospital stay, how often did doctors explain things in a way you could understand?
  • Before giving you any new medicine, how often did hospital staff tell you what the medicine was for?
  • Before giving you any new medicine, how often did hospital staff describe possible side effects in a way you could understand?
  • During this hospital stay, did doctors, nurses or other hospital staff talk with you about whether you would have the help you needed when you left the hospital?
  • During this hospital stay, did you get information in writing about what symptoms or health problems to look out for after you left the hospital?
  • When I left the hospital, I had a good understanding of things I was responsible for in managing my health.
  • When I left the hospital, I clearly understood the purpose for taking each of my medications.

As noted by the authors of this book, the New England Journal of Medicine “found that quality of care was significantly better in hospitals that performed better on HCAHPS” (Studer, & Robinson, 2010). The aim of this project is to improve health communication between providers and patients, and also to empower patients through education of their illness and provide access to resources.


Studer, Q., & Robinson, B. (2010). The HCAHPS handbook: Hardwire your hospital for pay-for-performance success. Gulf Breeze, FL: Fire Starter Pub.

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