AHRQ Views: Blog posts from AHRQ leaders
AHRQ’s Unique Role in Developing Surveys to Measure Patients’ Experience With Their Health Care
As a general internist by training and a primary care physician in practice, I can personally attest to the importance of understanding more fully the patient’s experience of care. I am also a health services researcher who appreciates the rigor with which AHRQ’s Consumer Assessment of Healthcare Providers and Systems (CAHPS®) was developed and implemented more than 20 years ago.
CAHPS is in many ways a success story at AHRQ and for the country. CAHPS surveys cover topics that are important to consumers, and they focus on aspects of quality that consumers are best qualified to assess, such as the communication skills of providers.
CAHPS surveys are used by a variety of organizations, including the Centers for Medicare & Medicaid Services, State Medicaid programs, commercial payers, hospitals, group practices, and accrediting organizations, such as the National Committee for Quality Assurance. Current uses for CAHPS include quality improvement, mandated reporting, accreditation, and participation in value-based reimbursement programs.
A new podcast explains the benefits of using AHRQ’s CAHPS surveys, which provide concrete, actionable feedback on care provided by health plans, hospitals, medical offices, nursing homes, home health agencies, and ambulatory surgery centers. But we know that CAHPS isn’t perfect. It’s challenging to get eligible individuals to complete the survey and to get consumers activated to use the information the survey results provide.
Further, we know that there is an emerging alternative in the form of narrative reports such as those available online to rate restaurants, hotels, and other services. That’s why we’re working on a project to see what value narrative reporting could bring to the suite of CAHPS surveys. The goal? To see if we can accurately capture patient experiences of health care via a narrative account, and then see how that information could potentially expand the capabilities of CAHPS.
Unlike online reviews of restaurants or hotels, we are using a sampling approach that aims to ensure that respondents are representative of all patients relevant to a CAHPS survey. We also tested a structured set of five open-ended questions to determine how well responses compare with information gleaned from in-depth interviews within a sample of survey respondents.
We are encouraged by what we’ve learned to date. The responses to the five open-ended questions appear to be balanced and broadly representative of patients’ experiences. We’ve also helped Massachusetts and California incorporate these questions into a pilot test of the CAHPS Clinician and Group Survey.
CAHPS has played a critical role in standardizing the approach to measuring the patient experience in health care. However, as a research Agency, we always have to ask ourselves how we can improve our approach to using research to improve quality. Patient narratives may be one such way to accomplish this goal by providing even more insight into patient experience of care. AHRQ is committed to exploring the use of patient narratives, and I look forward to keeping you updated on what we learn.