title: Organizational characteristics and patient experiences with hospital care: a survey study of hospital chief patient experience officers.
abstract: Beginning in fiscal year 2013, scores based on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) constitute 30% of incentive-based payments from Medicare's Value-Based Purchasing (VBP) initiative. Yet there is little empirical work to understand hospital approaches to improving the patient experience. In this study, chief patient experience officers at 416 VHA hospitals were surveyed to assess the relationship between organizational characteristics and publicly reported HCAHPS scores. Of 416 institutions, 143 (34.4%) participated. Respondents reported that boards (68%) and chief executive officers (81%) viewed the patient experience as extremely important. In contrast, they reported that in only 15% and 34% of hospitals, respectively, physicians and nurses were supportive of efforts to improve the patient experience. Hospitals with collaborative cultures and higher physician engagement had higher VBP total HCAHPS scores (6.9 points and 8.2 points higher, respectively; both P < .05). These areas should be addressed to improve the patient experience in provider organizations.
authors.affiliation: Duke University Fuqua School of Business, Durham, NC.
authors.forename: Matthew
authors.initials: M
authors.lastname: Manary
authors.affiliation: Duke University Fuqua School of Business, Durham, NC.
authors.forename: Richard
authors.initials: R
authors.lastname: Staelin
authors.affiliation: VHA Center for Applied Healthcare Studies, Dallas, TX.
authors.forename: Keith
authors.initials: K
authors.lastname: Kosel
authors.affiliation: Duke Clinical Research Institute, Durham, NC.
authors.forename: Kevin A
authors.initials: KA
authors.lastname: Schulman
authors.affiliation: Duke University Fuqua School of Business, Durham, NC Department of Emergency Medicine, University of North Carolina, Chapel Hill, NC swglick@med.unc.edu.
authors.forename: Seth W
authors.initials: SW
authors.lastname: Glickman
mesh_terms: D016542:Chief Executive Officers, Hospital / Q000523:psychology; D003142:Communication; D004493:Education; D005246:Feedback; D006291:Health Policy; D006739:Hospital Administration / Q000379:methods*; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D009042:Motivation; D009726:Nurses / Q000523:psychology; D015279:Organizational Culture; D017060:Patient Satisfaction; D010820:Physicians / Q000523:psychology; D062505:Value-Based Purchasing
keywords: health policy; patient experience; quality; value-based purchasing