Measuring Patient's Hospital Care Experiences: Development of a National Standard

The Agency for Healthcare Research and Quality (AHRQ) is beginning a process, under its CAHPS® II initiative, to develop a national standard for assessing hospital patient experiences. This process will result in a survey instrument and methodology designed to measure and publicly report patient experiences with hospital care.

Background

AHRQ has been the Nation's leader in establishing standards for measuring experiences with the U.S. health care system. The development of the Consumer Assessment of Health Plans (CAHPS®) was and continues to be ground-breaking work that provides the foundation for similar initiatives. To date, CAHPS® has not addressed hospital patient experiences.

Leaders from across the U.S. health care industry have called for a response to the need to assess the experiences of hospital patients.

• In Crossing the Quality Chasm, the Institute of Medicine listed patient-centered care as one of six aims for improvement. The dimensions of patient-centered care are:
  1. Respect for patients' values, preferences, and expressed needs.
  2. Coordination and integration of care.
  3. Information, communication, and education.
  4. Physical comfort.
  5. Emotional support—relieving fear and anxiety.
  6. Involvement of family and friends.
  7. Continuity and transition.
  8. Access to care.
  Measuring these dimensions will require a standard instrument that produces reliable, consistent results.
• The National Quality Forum (NQF) has recommended several priorities for research, development, and further investigation for suitable performance measures for acute hospital inpatients. One NQF priority area is the need to measure patient experiences with inpatient care.

The Director of AHRQ and the Administrator of the Centers for Medicare & Medicaid Services (CMS) have established a priority to develop a standard for measuring and publicly reporting hospital patient experiences. CMS and AHRQ have embraced a goal of developing the standard and releasing quality data on hospitals within the next year.

Path Forward

In response to this overwhelming need, AHRQ has, through a collaborative process with CMS and other Federal agencies and interested groups, begun the process for developing a national standard.

During the next year, AHRQ will undertake a plan to develop the national standard and place the standard within the public domain.

AHRQ's path forward includes the following steps:

• Stakeholder Meetings: A series of public meetings will be held to identify the issues, concerns and interests of the health care community.
• Sponsorship: Identifying potential sponsors who will fund, assist in development, and ultimately manage a process for implementing and maintaining the national standard.
• Research Plan: The process through which measures will be defined and a call for applicable instruments will be made. Instruments submitted by industry will be evaluated to determine if they meet the measurement needs and what additional development is necessary. Once consensus on the national standard has been reached, actions will be taken to place the resulting work in the public domain and instrument testing will be completed.
• Implementation Plan: The process for implementing the standard nation-wide will be established. This will include information related to data collection, analysis, and public reporting. Additionally, Federal rules requiring the use of the standard will be published.

Further Information

Questions regarding this CAHPS® initiative should be directed to Charles Darby at CDarby@ahrq.gov or by phone at (30l) 427-1324.

Additional Resource: Exploring a National Standard for Measuring Patients' Hospital Care Experiences: Meeting Summary, May 9, 2002.

Current as of June 2002

Internet Citation:

Measuring Patient's Hospital Care Experiences: Development of a National Standard. June 2002. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/qual/hspcahps.htm

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