Gulf Breeze Hospital in Florida Shows Consistent Improvement in Hospital Survey of Consumers

Gulf Breeze Hospital (GBH), a 65-bed, acute-care facility near Pensacola, FL, has improved patient experiences by using AHRQ's Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS^®), a standardized survey measuring the perceptions of recently discharged patients to help improve patient care experiences. The survey was developed through a partnership with AHRQ and the Centers for Medicare & Medicaid Services.

Patsy Myers, R.N., M.S.N., vice president of operations at GBH, said the HCAHPS scores provide patients' perspectives and help design safe care.

"Patient safety has always been important at the hospital," Ms. Myers noted. "We watch our scores carefully and make changes to improve, as needed." HCAHPS survey results have helped GBH create strategies to address four quality measures of the patient experience—pain control, quiet at night, doctor communication, and cleanliness.

The hospital showed the most improvement in the area of pain control. All staff are educated about the importance of pain assessment, which includes explaining the expectation of pain to patients. The hospital uses a numeric scale to help patients communicate their pain level.

"Each patient has a specific plan of care for pain control that involves ongoing monitoring and feedback for pain assessment and reassessment. Staff documents this information in the patient's record," Ms. Myers explains. In addition, the hospital places information boards in every patient's room for sharing pain goals during shift changes.

In addition, GBH incorporated the physical therapy department to help manage pain in post-operative patients. "The physical therapists help address expectation of pain with patients prior to their surgery and therapy," Ms. Myers said. The measure of "pain well-controlled" improved from 76 percent in 2012 to 93 percent in 2014.

The HCAHPS surveys also helped the hospital address quality issues related to noise reduction, provider communication, and room cleanliness.

To address noise reduction and promote a quieter atmosphere, the hospital implemented a strategy for dimming the lights during the evening shift. "This serves as a visual cue for visitors," Ms. Myers explained. "It lets them know they can stay, but that it is getting late and patients need to rest." The HCAHPS scores show that the hospital exceeded its target and improved in this area, raising scores from 65 percent in 2013 to 78 percent in 2014.

To help doctors improve in the area of doctor-patient communication, the HCAHPS questions related to patient communications are posted in common areas. Ms. Myers noted, "The doctors can see them, read them, and be reminded of their importance." The communication scores are also highlighted at staff meetings.

To improve the cleanliness measure, the hospital made modifications in the trash pick-up time. The "cleanliness" aspect became a collective effort; not only are environmental housekeeping personnel involved, all staff members participate. The HCAHPS survey results reflect that the hospital exceeded its target score in 2014.

GBH is part of Baptist Health Care, a not-for-profit health care system that has operated facilities in Florida and Alabama for over 60 years.