3 Tips for Aligning HCAHPS Scores and Outcomes in Hospitals

Posted by Brenda Aubin on September 15, 2016
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HCAHPS scores have been a hot topic in healthcare ever since CMS started awarding five-star ratings to hospitals based solely on HCAHPS scores in spring 2015. However, a new study from Quantros is shaking up the assumption that higher HCAHPS scores correlate with better patient outcomes. Interestingly, the Quantros study directly contradicts a study by Harvard researchers that was published in the Journal of the American Medical Association’s Internal Medicine publication just last year. That study found a positive correlation between patient satisfaction-based ratings and patient outcomes. So why the divide?

According to Becker’s Hospital Review, Quantros believes its study contrasts findings from the JAMA Internal Medicine study for two main reasons:

  1. The Harvard study used HCAHPS data from the second quarter of 2014 through the first quarter of 2015 and linked it to Medicare patient safety outcomes from 2013, meaning patient experience scores were compared with outcomes from different patient populations.
  1. The Harvard study used outcomes data from just three conditions (heart attack, pneumonia and heart failure).

In contrast, the Quantros study evaluated the performance of all CMS star-rated hospitals using a composite outcomes score inclusive of mortality rates, complications rates, and AHRQ patient safety indicators for all clinical conditions at risk for an adverse event.

The results? Nearly half (47%) of 5-star hospitals were found to have composite outcome scores below the national average with 2, 3, and 4-star hospitals having the lowest percentage of poor performing hospitals.


The takeaway, at least for the time being, is that the current method for measuring and rating patient satisfaction doesn’t equate to reliable data about patient safety or patient outcomes.

Hospitals can’t take shortcuts and focus on high marks for patient satisfaction while leaving issues surrounding patient safety and outcomes unaddressed. While there is short-term gain in boosting patient satisfaction scores, eventually the truth will come out. This is why making sustainable changes to processes, procedures and internal communication is so important.


Here are three tips for creating a sustainable plan that aligns patient satisfaction and outcomes:

  1. Start by identifying communication gaps. Nurses are the front lines of your hospital. Are they equipped with the technology and tools they need to stay coordinated, keep track of their patients, and provide quality care? What is the process for communicating patient requests? Are these tasks measurable? If not, it’s time to consider the technology that many hospitals have already embraced to transform patient safety and communication among their staff. (Not sure where to start? Read our case study about how Androscoggin Valley Hospital reduced patient falls by 65% after implementing Amplion Alert.)
  2. Examine both internal and external data. Internal process and productivity technology can provide real-time data that helps determine proper staffing levels and room for improvement. However, hospital leaders must also look externally to their peers and competitors when it comes to comprehensive assessment. This allows your team to look at overall performance and room for improvement relative to the industry, which may ultimately aid in decisions about new technology, processes and training.
  3. Find the right data experts, and make sure they understand the clinical side of operations. The importance of partnering with data and technology vendors and experts who understand the clinical setting cannot be understated. This knowledge allows your data team to understand the constraints of your own healthcare system more readily, break down data silos, and provide the best solutions more quickly. It also increases the chances of successful implementation, adoption and training when it comes to new technology for your staff. That’s why we collaborate and co-create solutions with IT and nursing leadership to ensure we are solving their pain points and empowering—rather than hampering-- their clinical teams.

As our industry, researchers and government continue to evolve in how they measure patient satisfaction and outcomes, hospitals can begin to make small changes like the ones outlined above to foster an enduring, sustainable culture of change that aligns patient outcomes and satisfaction. A culture that nurtures data-driven decision-making, constructive communication and openness to change is the best path forward to better execution of strategy, improved patient safety, employee retention, and improved bottom lines.

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Topics: Blog, Patient Safety, Patient Experience

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