We’ve mentioned the HCAHPS many times on this blog. The Hospital Consumer Assessment of Healthcare Providers and Systems survey, based on twenty-seven questions put to patients about their hospital experience, was designed by the Centers for Medicare and Medicaid Services of the US Department of Health and Human Services to “capture uniform information on hospital care from the patient’s perspective”.
HCAHPS has been billed as a “call to action to healthcare leaders and staff” for improving service delivery. For example, Hospitals in Pursuit of Excellence has produced a “Health Care Leader Action Guide to Effectively Using HCAHPS”. (HPOE is “the American Hospital Association’s strategic platform to accelerate performance improvement and support delivery system transformation in the nation’s hospitals and health systems”.)
These score literally mean money to hospitals: their federal reimbursement rates will depend on them. Naturally, then, consultants are offering to help raise hospitals’ scores. In addition to consultants, many players are getting on this bandwagon; for example, Human Resources wants a part of the action. Nurses, too, certainly have a valid claim to be instrumental in affecting these ratings.
In a move which is already inspiring puns and ridicule, CMS is considering “graphical display” of this information, i.e., star ratings. It works for restaurants, plays and movies – so why not hospitals, which after all have been urged to consider themselves in the entertainment business? How long before we see listings such as these
AMALGAMATED MAJOR HOSPITAL – First rate in everything from cardiology to urology. But we especially recommend the appendectomy – it’s the best anywhere. And every discharged patient gets a free candy bar.
FANCY MODERN CLINIC – Some specialties may be a little below standard. We particularly would urge you to avoid heart surgery; there have been just too many deaths. But whatever they lack in other respects, they make up for in amenities: the largest TV channel section, first rate cuisine, and complimentary hair care.
NEIGHBORHOOD MEDICAL INSTITUTION – Really dull care in a very drab building. Maybe OK for something minor like an ingrown toenail, but don’t risk your life on major surgery here. And the nurses’ uniforms are really tacky.
Well, it could happen. And it is all part of a trend of number worship. You can see the same tendency in education, where emphasis on tests score has spawned an industry of consultants, led often to cheating, and very likely been detrimental to actual learning.
Let’s hope health care doesn’t experience cheating scandals! Using numerical measures certainly can be valid, but too much of anything is a bad thing. Even for choosing a restaurant, it’s not all in the stars.
–Jim Murphy has a solo consulting practice called Management 3000, focusing on organizational development and change management. Formerly he led the Massachusetts Bay Organizational Development Learning Group, was Human Resources Director for the City of Boston Assessing Department, and served as a consultant with the Boston Management Consortium. His consulting practice includes management coaching as well as research and writing on employee relationships, leadership, healthcare and collaborative practices. Having produced newsletters for several organizations and being a frequent content writer for the”Confident Voices in Healthcare” blog, he is interested in writing and research opportunities, as we all consulting and coaching.