Patients' perception of care trending up 'across the board,' says Press Ganey CMO Thomas Lee

Healthcare quality improvements are working, according to a new analysis, and patients’ perceptions of the care they receive are improving in tandem.

Researchers at Press Ganey examined trends in certain measures of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) between 2013 and 2017 and compared them to internal data and surveys. During that five-year window, the number of patients giving their hospitals high overall rating scores increased steadily, and hospitals improved on nearly every HCAHPS measure between 2015 and 2016, according to the report.

Thomas Lee, M.D., chief medical officer at Press Ganey, told FierceHealthcare in an interview that the findings show that healthcare is improving overall and across many dimensions of care.

“Part of that message, the scary message, is if you’re standing still and you’re not improving then you’re slipping behind,” Lee said. “The less scary, but really interesting message, is how much improvement is happening across the board.”

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Press Ganey identified 10 elements that it determined were most associated with high overall rating performance on the HCAHPS:

  1. Nurses treated patients with respect and courtesy.
  2. Staff worked as a team.
  3. Nurses were friendly.
  4. Nurses were skilled.
  5. Nurses listened carefully to patients.
  6. The hospital was attentive to patient needs.
  7. The hospital was responsive to patient concerns and complaints.
  8. Nurses did not have an attitude about complaints.
  9. Staff did everything to manage pain.
  10. Nurses kept patients informed.

Lee said these 10 areas offer focus for providers looking to improve care quality, and they demonstrate how much patients value team-based care and effective communication with nurses. And improving teamwork doesn't just lie with nurses, he said.

“Teamwork is not just a nursing issue,” Lee said. “It requires doctors like me to also be good team members.”

Only one metric included in the study had negative results in meeting patient needs: pain management. Though pain management was one of the elements identified in the report as correlating with improved performance, “pain-well controlled” was the only studied metric that trended downward between 2015 and 2016.

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Lee said that pain management is a complex issue, and the report highlights that it is often “really hard to get right” as physicians seek a balance between patient demands and reducing opioid prescriptions because of the opioid crisis.

“We don’t want to give too many opioids, but there is a downside that might come from having too much restraint,” he said. “I do think there is some middle ground.”