Leapfrog report highlights hospitals' patient communications, care transition shortcomings

A female doctor speaks to a male patient
Poor communication when instructing patients on home care or failing to empower guardians to speak up with their concerns can translate to issues of patient safety, according to the Leapfrog Group. (Getty/FatCamera)

A new Leapfrog Group report reviewing nationwide patient experience surveys suggests hospitals have room for improvement when discussing medicines and the transition to home care.

The findings—which are based on Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey results—also indicate that pediatric hospitals could do a better job empowering parents and guardians to voice concerns about their child’s treatment.

On the other hand, Leapfrog found hospital outpatient departments and ambulatory surgery centers (ASCs) both fared well for four different measures of patient experience. Still, patients rated their experiences in the latter setting significantly higher than the former, according to the surveys.

"Patient experience surveys are the voice of the American patient, and that voice should be the first authority we listen to," Leah Binder, president and CEO of The Leapfrog Group, said in a statement. "We are worried about signs of patient safety problems, particularly in pediatric units, where parents appear hesitant to raise concerns about mistakes. We also see issues with communication that can lead to patient harm. Outpatient facilities and particularly ASCs appear to be rated more favorably by their patients, which is promising, but all facilities have work to do."

Leapfrog’s latest report combines CAHPS survey data collected through the group’s 2019 and 2020 hospital and ASC surveys and the Centers for Medicare & Medicaid Services. The findings cover 3,571 hospitals, 99 pediatric hospitals, 363 ASCs and 1,252 hospitals that provide outpatient care.

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Hospitals most often received the highest marks from patient when rating their discharge information and communications with doctors or nurses, with an average 86.9%, 80.2% and 79.7% of patients indicating the most favorable survey response for these respective measures.

But while most patients said many hospitals asked whether they would have help at home or provided information on what symptoms to look out for, just over half (52.1%) indicated that they clearly understood what was required of them or felt their preferences were taken into account, according to Leapfrog. Similarly, less than two-thirds of patients gave their hospital the most favorable response when it came to explaining new medicines and their side effects.

Contrasting that were data from the pediatric hospitals, where an average 80.6% of parents or guardians checked the top box score for communications about a patient’s medicines.

The respondents also scored pediatric hospital nurses (79% average top box score) and doctors (74.8% average top box score) relatively well on their ability to communicate with young patients, but the top scores dipped down to an average 62% when parents and guardians rated how comfortable they felt reporting concerns regarding care.

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“A parent by their child’s bedside throughout a hospital stay may be better equipped than a medical provider to notice when something is wrong,” Leapfrog wrote in the report. “Feeling prepared to speak up immediately when they observe problems is a critical patient safety indicator, improving the odds of preventing or reducing harm from errors.”

Adult patients almost always gave ASCs (97.3% average) and hospital outpatient departments performing same-day surgery (96.4% average) top marks regarding their staff and the cleanliness of the facilities. Those response rates dipped to their lowest for both settings when patients were asked whether they would recommend the facility to family or friends—an 82.1% average top box score for hospital outpatient departments and an 87.6% average for ASCs.

ASCs also outperformed hospital outpatient departments in the other patient experience survey domains reviewed by Leapfrog, which the group noted could shed light on why patients who have an opportunity to research facilities for their same-day surgery in advance more often choose ASCs.

Much like its well-known patient safety reports, Leapfrog wrote that these survey data are key tools for healthcare consumers selecting where to receive their care and highlighted how to find facility-specific results online. The group also said the findings can help facility leadership “understand how their patients experienced care in the facility and be able to identify gaps tied to safety and quality."