Survey Updates and Quality Improvement Resources

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Slide 0

Survey Updates and Quality Improvement Resources

Julie A. Brown, Rand Corporation

AHRQ 2012 Annual Conference
Bethesda, MD
September 9, 2012

Images: Consumer Assessment of Healthcare Providers and Systems (CAHPS®) and AHRQ logos appear at the top of the slide.

Slide 1

The CAHPS Family of Surveys

• Ambulatory Care Surveys:
  • CAHPS Clinician & Group (C&G) Survey.
  • CAHPS Health Plan Survey.
  • CAHPS Surgical Care Survey.
  • ECHO® Survey.
  • CAHPS Dental Plan Survey.
  • CAHPS American Indian Survey.
  • CAHPS Home Health Care Survey.
• Facility Surveys:
  • CAHPS Hospital Survey (HCAHPS).
  • CAHPS In-Center Hemodialysis Survey.
  • CAHPS Nursing Home Surveys.

Slide 2

Survey Review and Update

• Update existing surveys to reflect "best survey science."
• Began with core surveys:
  • Health Plan version 5.0.
  • Clinician & Group version 2.0.
  • Surgical Care version 2.0.
  • Working with stakeholders (e.g. CMS [Centers for Medicare & Medicaid Services], NCQA [National Committee for Quality Assurance]).
• Working on supplemental items:
  • CG-CAHPS Adult supplemental items available.

Slide 3

Health Plan Survey 5.0

• Simplified Access items.
• Made access to specialist item consistent.
• Improved item on access to care, test, and treatment.
• Made chronic condition identifying items consistent.
• Added self-reported mental and emotional health item.

Slide 4

Simplified Access Items

• Access to urgent and non-urgent care asked about getting care "you thought you needed":
  • Removed "you thought."
  • Made consistent across CAHPS Surveys.
• Non-urgent care items was defined as "not counting the times you needed care right away":
  • Updated to "a check up or routine care."
  • Made consistent across CAHPS Surveys.

Slide 5

Consistent Specialist Item

• Specialist item asked "how often was it easy to get appointments with specialists":
  • Revised to "how often did you get an appointment to see a specialist as soon as you needed."
  • Made consistent across CAHPS Surveys.

Slide 6

Care, Tests, and Treatment Items

• Asked about ease of getting care, tests, and treatment you thought you needed through your health plan:
  • Dropped "you thought":
    • Consistency across surveys.
  • Dropped "through your health plan."
  • Moved from "Your Health Plan" section to "Your Health Care in the Last 12 Months" section:
    • Clarifies who is providing care, tests, or treatment.
    • Screener item no longer needed.
    • Consistent across surveys.

Slide 7

Chronic Condition Identifiers

• Chronic condition identifying items standardized across CAHPS Surveys.
• Initial screening item asked whether you saw a doctor or other health provider 3 or more times for the same problem or condition:
  • Simplified to got health care 3 or more times for the same problem or condition.
• No changes to other items in the chronic condition identifier.

Slide 8

Self-reported Mental or Emotional Health Item

• Respondent rating of overall mental or emotional health.
• Added after the overall health status rating.
• Powerful case-mix adjuster.
• Made consistent across surveys.

Slide 9

C&G Survey 2.0

• Changed how we refer to focal provider.
• Made minor improvements to item wording.
• Moved chronic condition screening items to supplemental items.
• Added mental health item.
• Finalized:
  • Child 12-Month Survey.
  • Adult Visit Survey.

Slide 10

Surgical Care Survey 2.0

• Updated to make consistent with CG-CAHPS Survey 2.0.
• NQF [National Quality Forum] endorsed in 2012.

Slide 11

Key Stakeholders

• Communicated to CMS:
  • Plans to adopt for use in 2014.
• NCQA adopted 5.0 core survey for use in 2013:
  • Includes updated shared decision-making items.
  • Other changes to HEDIS items (CAHPS supplemental items) will be evaluated for the 2014 survey.

Slide 12

Use of CAHPS Surveys for QI

• CAHPS Surveys play an important role as a QI tool for organizations to use standardized data to:
  • Identify relative strengths and weaknesses in their performance.
  • Determine where they need to improve.
  • Track their progress over time.

Slide 13

QI Resources

• The CAHPS Improvement Guide.
• Reports and case studies.
• Supplemental items.
• Presentation slides and transcripts.

Slide 14

The CAHPS Improvement Guide

• Comprehensive resource for health plans, medical groups, and other providers seeking to improve their performance in the domains of quality measured by CAHPS Surveys.
• Use of the Guide can help organizations:
  • Cultivate an environment that encourages and sustains QI.
  • Analyze the results of CAHPS Surveys to identify strengths and weaknesses.
  • Develop strategies for improving performance.

Slide 15

Guide Content

• Why improve patient experience?
• Are you ready to improve?
• Analysis of CAHPS results.
• Quality improvement steps.
• Improvement interventions.

Slide 16

Reports and Case Studies

• Case studies of quality improvement series.
• A Tale of Three Practices: How Medical Groups are Improving the Patient Experience.
• In-Center Hemodialysis Quality Improvement Project.
• Profiles of High-Performing Family- and Patient-Centered Academic Medical Centers.
• Go Guide—Transform Care in Six Steps.
• Patient-Centered Care: What Does It Take?
• Providing Performance Feedback to Individual Physicians.

Slide 17

Supplemental Items for QI

• Many of the supplemental items for the CAHPS Health Plan and Clinician & Group Surveys can help users to develop and monitor QI efforts in multiple areas of care.
  • Access and After Hours Care.
  • Communication "drill down."
  • Care Coordination.

Slide 18

Presentation Slides and Transcripts

• User Group Meetings.
• Webcasts.
• Podcasts:
  • QI podcast series.

Slide 19

QI Podcast Series

• Case for Improving Patient Experience.
• Creating an Improvement Culture.
• The Role of Leadership in QI Efforts.
• Teamwork in QI.
• Human Resources Issues.
• Qualitative Methods for Patient Experience.
• Identifying Areas to Improve.
• Improving Communication.
• Factors Affecting Care Coordination.
• Creating an Effective Customer Service Training Program.
• Tackling Low Literacy.

Slide 20

CAHPS User Network

• Although the CAHPS Web site is temporarily changing, AHRQ's support for CAHPS has not changed
• AHRQ will continue to offer technical assistance regarding the use of CAHPS products via telephone and email

Call: (301) 427-1017
Email: cahps1@ahrq.hhs.gov