Using HCAHPS data to improve hospital care quality

2016 ◽  
Vol 28 (6) ◽  
pp. 974-990 ◽  
Author(s):  
John C. Carter ◽  
Fred N. Silverman
Keyword(s):  
Patient Satisfaction ◽  
Survey Data ◽  
Healthcare Providers ◽  
Hospital Management ◽  
Care Quality ◽  
Future Research ◽  
Content Type ◽  
Pareto Analysis ◽  
Hospital Administrators ◽  
Patient Satisfaction Scores

Purpose The purpose of this paper is twofold: to enable hospital administrators to increase reimbursement rates under value-based purchasing (VBP) by understanding the process by which the Centers for Medicare and Medicaid Services (CMS) calculate and use performance scores from the Hospital Consumer Assessment of Healthcare Providers and Systems survey of patient experience; to apply statistical methods to determine what dimensions of patient care have the greatest impact on overall satisfaction scores and thus reimbursement. Design/methodology/approach The expository purpose was met by locating, analyzing and interpreting published CMS documentation related to VBP to explain the complex methods used to convert raw survey data to total patient satisfaction scores on seven dimensions. The raw data on 2,984 hospitals were cleaned and correlation and regression analysis used to measure the relationship between raw survey scores and overall patient satisfaction scores. Finally, Pareto analysis was used to show the relative influence of each dimension on satisfaction performance scores. Findings Nursing communications accounted for 75 percent of the variance in the patient satisfaction domain score in a stepwise regression. Research limitations/implications This research focusses only on the patient satisfaction component of VBP, over which hospital administrators have significant control. Future research could explore how hospital management can improve scores on clinical outcomes, process and efficiency. Practical implications Shows hospital management the most influential methods for improving their patient satisfaction scores and reimbursement under VBP. Originality/value Offers a managerially focussed explanation of how patient satisfaction scores are computed from raw survey data and how statistical analysis of the data can be used to improve quality.

Patient perceptions of quality: analyzing patient satisfaction surveys

2015 ◽  
Vol 35 (8) ◽  
pp. 1158-1181 ◽  
Author(s):  
Roberta S. Russell ◽  
Dana M. Johnson ◽  
Sheneeta W White
Keyword(s):  
Patient Satisfaction ◽  
Care Provider ◽  
Healthcare Providers ◽  
Academic Research ◽  
Quality Of Healthcare ◽  
Care Quality ◽  
Patient Perceptions ◽  
Medical Specialties ◽  
Content Type

Purpose – Healthcare facilities are entering an era of increased oversight and heightened expectations concerning both reduced costs and measureable quality. The US Affordable Care Act requires healthcare organizations to collect certain metrics, including patient assessments of quality, in order to monitor and improve the quality of healthcare. These metrics are used as a basis for graduated insurance reimbursements, and are available to consumers as an aid in selecting healthcare providers and insurance plans. The purpose of this paper is to provide healthcare providers with the analytic capabilities to better understand quality of care from the patient’s point of view. Design/methodology/approach – This research examines patient satisfaction data from a multi-specialty Medical Practice Group, and uses regression analysis and paired comparisons to provide insight into patient perceptions of care quality. Findings – Results show that variables related to Access, Moving Through the Visit, Nurse/Assistant, Care Provider and Personal Issues significantly impact overall assessments of care quality. In addition, while gender and type of care provider do not appear to have an impact on overall patient satisfaction, significant differences do exist based on age group, specialty of the physician and clinic type. Originality/value – This study differs from most academic research as it focusses on medical practices, rather than hospitals, and includes multiple clinic types, medical specialties and physician types in the analysis. The study demonstrates how analytics and patient perceptions of quality can inform policy decisions.

Financing employee healthcare: fusing the preferences of employees in decision-making

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
George Ouma Ochieng'a ◽  
Maurice Ogada
Keyword(s):  
Health Care ◽  
Cost Benefit Analysis ◽  
Healthcare Providers ◽  
Coastal Region ◽  
Probit Analysis ◽  
Future Research ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Content Type ◽  
Employee Preferences

Purpose Good health is important for the happiness and productivity of employees of any organization and a nation. With the declining government funding for public Universities in Kenya, providing health cover for employees is a real challenge. Thus, the universities have to explore widely acceptable and sustainable options. This study aims to explore the correlations of employee preferences for health care schemes and evaluated the cost implications of each of the available Schemes.Design/methodology/approach The study applied a multinomial probit analysis on cross-sectional data from Taita Taveta University (TTU) in Kenya's coastal region. Cost-benefit analysis was used to rank alternative healthcare schemes. For triangulation of information, individual interviews were supplemented with key informant interviews.Findings Two sets of factors, personal attributes of employees and the attributes of the health care provider, were found to drive employee preferences for health care schemes. Thus, the universities need to consider these attributes in their choice sets of health care schemes to gain employee support.Research limitations/implications The study was based on a cross-sectional survey that may not capture the dynamic elements in institutional management. Thus, future research may build panel data on the current one for further analysis.Practical implications The study found that household characteristics and the perceived attributes of the healthcare providers are key drivers of the preferences. Thus, it is important to consider the characteristics of the employees (for example, age, family sizes, etc.) and attributes of healthcare providers before selecting a healthcare scheme for the workersOriginality/value This is a pioneer study on the choice of healthcare scheme for institutions of higher learning in Kenya. Universities are made aware of what informs employee's preferences for health schemes. This is important for tailoring health care schemes to match employee preferences for greater satisfaction.

Maintenance of public hospital buildings in Nigeria – an assessment of current practices and policy options

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Andrew Ebekozien ◽  
Okechukwu Saviour Dominic Duru ◽  
Okhatie Emmanuel Dako
Keyword(s):  
Health Care ◽  
Public Hospital ◽  
Practical Implication ◽  
Design Stage ◽  
Future Research ◽  
Policy Options ◽  
Content Type ◽  
Hospital Administrators ◽  
Automation Systems ◽  
The Government

Purpose The recent COVID-19 pandemic has exposed the declining conditions of many of the hospital buildings, especially in developing countries. Past studies have shown inadequate maintenance practices but how far regarding Nigerian public hospital buildings is yet to receive empirical research. This paper aims to investigate the underlying issues leading to inadequate maintenance practices and proffers policy options to improve Nigerian public hospital buildings via an unexplored dimension. Design/methodology/approach The study used a mixed research design method involving both qualitative and quantitative data. First, results from the qualitative phase were analysed and verified at the quantitative phase through a well-structured questionnaire, developed from the qualitative findings across hospital maintenance experts (work/maintenance department, health-care provider, design team and health-care building/service contractor) in Abuja, Lagos and Benin City. Findings Insufficient funds for maintenance works, absence of planned maintenance programmes, inadequately trained personnel, etc., emerged as the maintenance inadequacies in the public hospital buildings across the cities covered. The paper categorised the cause of inadequate maintenance practices of public hospital buildings into six groups: statutory requirements, design stage, construction stage, budget for maintenance task, managing maintenance unit activities and user’s perception regarding maintenance management. Research limitations/implications This paper is limited to maintenance practices of Nigerian public hospital buildings. Future research is needed to evaluate factors that will enhance outsourcing maintenance and the use of the 4th industrial revolution (building information modelling for refurbishment and building automation systems) amongst others in maintenance practices of public hospital buildings. Practical implications As part of the practical implication, the government and hospital administrators should make provision for adequate funding and accountability of annual maintenance budgetary allocation. Also, the government should establish a national maintenance policy for public infrastructure with an emphasis on preventive maintenance and contractor’s reputation, outstanding pedigree, technical and financial soundness during build maintenance contract award, etc., were recommended. Originality/value This paper reveals that the stakeholders, especially hospital administrators, policymakers and political office holders that are concern with maintenance budget, approval and disbursement concerning maintenance practices in public hospital buildings need to reawaken to her responsibility because of the inadequate implementation across the cities covered.

Total quality management: a critical literature review using Pareto analysis

2018 ◽  
Vol 67 (1) ◽  
pp. 128-154 ◽  
Author(s):  
Shweta Bajaj ◽  
Ruchi Garg ◽  
Monika Sethi
Keyword(s):  
Quality Management ◽  
Total Quality Management ◽  
Business Performance ◽  
Future Research ◽  
Clear Understanding ◽  
Total Quality ◽  
Content Type ◽  
Pareto Analysis ◽  
Generalized Framework ◽  
Critical Literature

Purpose Due to its impact on business performance total quality management (TQM) has gained a lot of importance by businessmen, managers, practitioners, and research scholars over the last 20 years. Therefore, the purpose of this paper is to critically assess the literature on TQM and find out the areas where future research is required. Design/methodology/approach To achieve this purpose the articles published in the last 20 years were studied in a systematic way and a snapshot of the same was prepared in the tabular format with points such as year and journal of publication, application and country, statistical method used, and findings of the study such as practices and impact of TQM. After identifying the practices and impact of TQM a quality tool “Pareto Analysis” was applied on them for development of the model. Findings The findings provide the practices of TQM and its impact on the performance of a business. The gaps from the literature have been identified and areas for future research have been suggested. On the basis of the findings a generalized framework of TQM has been suggested which can be applicable irrespective of the sector. Practical implications The research will help academicians and future researchers to have a clear understanding of TQM in different rosters. Originality/value Ample literature is available on TQM but in the best knowledge of authors no study has taken place to integrate the reviews and findings of 102 research papers of the last two decades.

scholarly journals An Approach to Exploring Associations between Hospital Structural Measures and Patient Satisfaction by Distance-based Analysis

2021 ◽  
Author(s):  
Masumi Okuda ◽  
Akira Yasuda ◽  
Shusaku Tsumoto
Keyword(s):  
Patient Satisfaction ◽  
Healthcare Providers ◽  
Care Quality ◽  
Global Evaluation ◽  
Inclusion Criteria ◽  
Hospital Size ◽  
Structural Measures ◽  
Hospital Consumer Assessment ◽  
Consumer Assessment ◽  
Hospital Compare

Abstract Background: Patient satisfaction studies have explored domains of patient satisfaction, the determinants of domains, and score differences of domains by patient/hospital structural measures but reports on the structure of patient satisfaction with respect to similarities among domains are scarce. This study is to explore by distance-based analysis whether similarities among patient-satisfaction domains are influenced by hospital structural measures, and to design a model evaluating relationships between the structure of patient satisfaction and hospital structural measures.Methods: The Hospital Consumer Assessment of Healthcare Providers and Systems 2012 survey scores and their structural measures from the Hospital Compare website reported adjusted percentages of scale for each hospital. Contingency tables of nine measures and their ratings were designed based on hospital structural measures, followed by three different distance-based analyses - clustering, correspondence analysis, and ordinal multidimensional scaling – for robustness to identify homogenous groups with respect to similarities.Results: Of 4,677 hospitals, 3,711 (79.3%) met the inclusion criteria and were analyzed. The measures were divided into three groups plus cleanliness. Certain combinations of these groups were shown to be dependent on hospital structural measures. High value ratings for communication and low value ratings for medication explanation, quietness and staff responsiveness were not influenced by hospital structural measures, but the varied-ratings domain group similarities, including items such as global evaluation and pain management, were affected by hospital structural measures.Conclusions: Distance-based analysis can reveal the hidden structure of patient satisfaction. This study suggests that hospital structural measures including hospital size, the ability to provide acute surgical treatment, and hospital interest in improving medical care quality are factors which may influence the structure of patient satisfaction.

Hospital service quality and patient loyalty: the mediation effect of empathy

2018 ◽  
Vol 33 (8) ◽  
pp. 1176-1186 ◽  
Author(s):  
Yucheng Zhang ◽  
Long Zhang ◽  
Xin Zhang ◽  
Miles M. Yang ◽  
Shanshan Zhang ◽  
...  
Keyword(s):  
Service Quality ◽  
Survey Data ◽  
Customer Loyalty ◽  
Structural Equation ◽  
Social Identification ◽  
Mediation Effect ◽  
Future Research ◽  
Hospital Service ◽  
Content Type ◽  
Patient Loyalty

PurposeDrawing on social identification theory, this research aims to explore an important mechanism – patients’ perceived empathy from a hospital, which is defined as caring, individualized attention provided by the hospital – that explains how service quality influences patients’ loyalty to the hospital.Design/methodology/approachThis study adopts a structural equation modelling framework to estimate the mediation relationship between service quality and patient loyalty using two studies based on hospital employees and patients.FindingsIn Study 1, hospital staff survey data showed that service quality enhanced patients’ perceived empathy from the hospital. In Study 2, the authors confirmed and extended the findings of Study 1 by using patient survey data that suggested that patients’ empathy mediated the relationship between service quality and patients’ loyalty to the hospital.Originality/valueThe results of the two studies suggested that service quality increased patients’ empathy, which in turn improved patients’ loyalty to a hospital. The results extend the customer loyalty literature by exploring the critical antecedents and mechanisms of customer loyalty in the healthcare context. The studies interpret healthcare phenomena from the service aspect of fulfilling patients’ unique needs and providing a good hospital service experience. Moreover, the authors offer an insightful approach to explaining the service quality–patient loyalty linkage in the healthcare industry. Important theoretical and managerial contributions and suggestions for future research are discussed.

The impact of occupational stereotypes in human-centered service systems

2019 ◽  
Vol 30 (1) ◽  
pp. 132-155 ◽  
Author(s):  
Antje Sarah Julia Huetten ◽  
David Antons ◽  
Christoph F. Breidbach ◽  
Erk P. Piening ◽  
Torsten Oliver Salge
Keyword(s):  
Patient Satisfaction ◽  
Research Priorities ◽  
Service Systems ◽  
Service Research ◽  
Future Research ◽  
Patient Orientation ◽  
Occupational Stereotypes ◽  
Content Type ◽  
Mediating Mechanisms ◽  
The Impact

PurposeThe purpose of this paper is to explore the impact that occupational stereotypes held by customers have on value co-creation processes in human-centered service systems (HCSSs) like hospitals. Specifically, by exploring if and how customers’ (i.e. patients’) stereotypes toward frontline employees (e.g. nurses) affect their satisfaction as co-creators of value, this study responds to current service research priorities attempting to understand value co-creation in collaborative contexts like healthcare, and addresses calls to investigate the changing role of health care customers therein.Design/methodology/approachA field study was conducted in the context of German hospitals, which provides unique empirical evidence into the relationship between patients’ stereotypes toward healthcare professionals and their satisfaction with health services as well as the mediating mechanisms through which such stereotypes affect patient satisfaction.FindingsNegative (positive) stereotypes patients hold toward healthcare occupations decrease (increase) their satisfaction and are associated with perceptions of reduced (improved) patient orientation and patient participation in co-creation. However, only perceived patient orientation partially mediates the link between occupational stereotypes and patient satisfaction.Originality/valueThis study develops and tests new hypotheses related to occupational stereotyping in complex HCSSs, and extends previous research on stereotypes in service by exploring the previously unknown mediating mechanisms through which these impact value co-creation processes overall. It furthermore provides important guidance for future research about stereotyping in general, and its impact on value co-creation and HCSS, in particular.

Perceptions of care quality and the effect on patient satisfaction

2016 ◽  
Vol 33 (8) ◽  
pp. 1202-1229 ◽  
Author(s):  
Dana M. Johnson ◽  
Roberta S. Russell ◽  
Sheneeta W. White
Keyword(s):  
Patient Satisfaction ◽  
Service Quality ◽  
Multiple Regression ◽  
Paired Comparison ◽  
Time Frame ◽  
Care Quality ◽  
Content Type ◽  
Time Period ◽  
The Impact ◽  
Perceptions Of Care

Purpose This research models the impact of patient perceptions of care quality on overall patient satisfaction in a rural healthcare organization over a three-year time period. The purpose of this paper is to determine if the factors that influence perceptions of service quality change over time and if the change affects overall patient satisfaction. Design/methodology/approach Data were collected for three fiscal years (2012-2014) using a 36-question, Likert-scaled attitudinal survey. Multiple regression analysis was performed to identify which constructs of five different service quality dimensions were statistically significant in predicting overall patient satisfaction. Paired comparison of means and ANOVA F-tests highlighted significant differences across years and demographics. Findings Multiple regression models of overall patient satisfaction over a three-year time period had significant repeat variables, indicating salience of the dimensions and constructs of service quality that predict patient satisfaction. However, some dimensions of service quality did not remain significant from one year to another, indicating there may be a gap in the patient service cycle over an extended time frame. Originality/value This paper explored the sequential relationship between patient satisfaction survey data and perceptions of service quality over a multi-year time frame. The research focussed on outpatient medical clinics, while the majority of previous studies have focussed on acute care or inpatient stays. A longitudinal study is especially relevant for outpatient clinics where continuity of care is important.

Quality of health care and patient satisfaction

2010 ◽  
Vol 15 (2) ◽  
pp. 92-101 ◽  
Author(s):  
Hatice Camgöz‐Akdağ ◽  
Mosad Zineldin
Keyword(s):  
Health Care ◽  
Patient Satisfaction ◽  
Quality Management ◽  
Health Care Quality ◽  
Care Quality ◽  
Content Type ◽  
Management Processes ◽  
Future Direction ◽  
Effective Health Care

PurposeThe aim of this research is to examine the major factors affecting patients' perception of cumulative satisfaction and to address the question whether patients in Istanbul evaluate quality of health care to be similar or different to that of the Kazakhstani, Egyptian and Jordanian patients.Design/methodology/approachA conceptual model including behavioural dimensions of patient‐physician relationships and patient satisfaction has been used for approach. As the empirical research setting, this study concerns people who are or were patients once in Istanbul hospitals.FindingsThe questionnaire was taken from another research regarding Egyptian and Jordanian medical clinics. The same research was also done by the authors in Kazakhstan in 2008. A total of 48 items (attributes) of the newly developed five quality dimensions (5Qs) by the second author were identified to be the most relevant.Practical implicationsThe results of this study can be used by the hospitals to reengineer and redesign creatively their quality management processes and the future direction of their more effective health care quality strategies.Originality/valueA 5Qs model to measure the patients' satisfaction of medical care is proposed as for previous studies for Kazakhstanian, Egyptian and Jordanian hospitals. As mentioned previously the 5Qs model encompasses technical, functional, interaction, infrastructure and the atmosphere qualities and services. The results can be used by the hospitals to reengineer and redesign creatively their quality management processes and the future direction of their more effective health care quality strategies.

How and why Millennials are initiating conflict in vertical dyads and what they are learning

2017 ◽  
Vol 28 (5) ◽  
pp. 644-670 ◽  
Author(s):  
Avan Jassawalla ◽  
Hemant Sashittal
Keyword(s):  
Survey Data ◽  
Structural Equation ◽  
Equation Modeling ◽  
Future Research ◽  
Multiple Perspectives ◽  
Measurement Scales ◽  
Two Stage ◽  
Content Type ◽  
Entry Level ◽  
Modeling Methodology

Purpose The purpose of this paper is to contribute to extant conflict management theory by presenting evidence from a two-stage study of conflict initiated by pre-graduation Millennials in entry-level work environments. Design/methodology/approach The paper presents an inductively derived conceptual model, hypotheses and measurement scales grounded in Millennials’ voices. Then, based on survey data, the scales are tested for structural coherence, and hypotheses are validated using structural equation modeling methodology. Findings Most Millennials initiate conflict with older coworkers and supervisors in the workplace because of the hurt they feel over the unfairness they experience. While confronting their superiors, they take an aggressive stand (“you are wrong, you should change”) and learn that the organization is duplicitous and that they should initiate conflict with superiors in the future to protect against unfairness in a duplicitous organization. Research limitations/implications The findings and implications reflect the perspectives of Millennials who initiated conflict with superiors or more experienced coworkers in entry level workplaces. Reports of multiple perspectives and from other contexts are left to future research. Practical implications Millennials may well enter the workforce with attitudes and behaviors older coworkers and supervisors find aberrant. However, the interactions between Millennials, older generations and the socio-technical environment of entry-level workplaces lie at the root of the conflict Millennials initiate. Older generations may have implicitly produced – albeit to varying extents – opaque environments in which entry-level Millennials feel manipulated. Originality/value The study reports a relatively rare two-stage study that begins with exploration and discovery using qualitative data, and concludes with hypotheses tests based on survey data. A new context is explored; i.e. Millennials initiating conflict in vertical dyads. New concerns about the veracity of the entry-level work environment are raised.

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