The HCAHPS survey is designed to make patient perception of hospital stays into measurable data. The survey contains 32 questions in total about the patient’s hospital experience, and 21 core questions about the most critical aspects of the experience. Patient answers to these questions determine a hospital’s HCAHPS results, which are weighed 30% in the decision to award or withhold 1% of Medicare reimbursement.
Of all 32 HCAHPS questions, and 21 core questions, which are most relevant to a hospital’s Environmental Services department? EVS performance impacts results of the questions pertaining to hospital environment cleanliness and overall hospital impression. Survey recipients are asked these questions:
Question 8: During this hospital stay, how often were your room and bathroom kept clean?
Question 18: Using any number from 0 to 10, where 0 is the worst hospital possible and 10 is the best hospital possible, what number would you use to rate this hospital during your stay?
The Hospital Environment
The most relevant question to EVS in this category is:
8) During this hospital stay, how often were your room and bathroom kept clean?
This question is designed to measure a patient’s visual perception of cleanliness. Patients are able to answer this question with:
- 1 – Never
- 2 – Sometimes
- 3 – Usually
- 4 – Always
The presence of this question on the HCAHPS survey indicates the need for an efficient and effective EVS department. In order to achieve an optimal score of 4, patient rooms must consistently meet high standards of cleaning quality.
Overall Hospital Impression
The most important question to EVS in this category is:
18) Using any number from 0 to 10, where 0 is the worst hospital possible and 10 is the best hospital possible, what number would you use to rate this hospital during your stay?
This question measures the patient’s overall perception of the hospital, encompassing everything from care and attention from doctors and nurses to their perception of the hospital as a clean and safe environment.
Patients can respond to this question with any number between 0 (worst hospital ever) and 10 (best hospital possible).
The overall impression of the hospital is largely impacted by cleanliness – everything from debris in the parking lot, to the lobby’s cleanliness, to overflowing trash receptacles can negatively affect a patient’s overall perception of quality. Patients and visitors may not understand the complexities of the medical care they receive, but everyone understands “clean”.
This score is also affected by the demeanor of the staff in the hospital. The EVS staff is the second largest workforce in the hospital. If EVS staff members are friendly, ask for permission to enter rooms, and offer assistance, patients are more likely to remember their visit as positive. And on the other side of the coin, EVS employees who appear unhappy or stressed, and avoid interacting with patients and visitors, will negatively affect patient experience and their overall quality score.
In our next HCAHPS article, we’ll discuss in detail how the environmental services department can support overall hospital quality and positively affect HCAHPS scores.
For more information about the basics of HCAHPS, check out the first article in our series: HCAHPS: Just the Facts
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