title: Promising Practices for Achieving Patient-centered Hospital Care: A National Study of High-performing US Hospitals.
abstract: BACKGROUND
  Patient-centered care is integral to health care quality, yet little is known regarding how to achieve patient-centeredness in the hospital setting. The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey measures patients' reports on clinician behaviors deemed by patients as key to a high-quality hospitalization experience.
  
  
  OBJECTIVE
  We conducted a national study of hospitals that achieved the highest performance on HCAHPS to identify promising practices for improving patient-centeredness, common challenges met, and how those were addressed.
  
  
  METHODS
  We identified hospitals that achieved the top ranks or remarkable recent improvements on HCAHPS and surveyed key informants at these hospitals. Using quantitative and qualitative methods, we described the interventions used at these hospitals and developed an explanatory model for achieving patient-centeredness in hospital care.
  
  
  RESULTS
  Fifty-two hospitals participated in this study. Hospitals used similar interventions that focused on improving responsiveness to patient needs, the discharge experience, and patient-clinician interactions. To improve responsiveness, hospitals used proactive nursing rounds (reported at 83% of hospitals) and executive/leader rounds (62%); for the discharge experience, multidisciplinary rounds (56%), postdischarge calls (54%), and discharge folders (52%) were utilized; for clinician-patient interactions, hospitals promoted specific desired behaviors (65%) and set behavioral standards (60%) for which employees were held accountable. Similar strategies were also used to achieve successful intervention implementation including HCAHPS data feedback, and employee and leader engagement and accountability.
  
  
  CONCLUSIONS
  High-performing hospitals used a set of patient-centered care processes that involved both leaders and clinicians in ensuring that patient needs and preferences are addressed.
authors.affiliation: *Armstrong Institute for Patient Safety and Quality, Johns Hopkins Medicine †Department of Medicine, General Internal Medicine Division, Johns Hopkins University School of Medicine ‡Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD §Ain Shams University, School of Medicine, Cairo, Egypt ∥General Preventive Medicine Program, Johns Hopkins Bloomberg School of Public Health ¶Carey Business School, Johns Hopkins University #Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health **Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
authors.forename: Hanan J
authors.initials: HJ
authors.lastname: Aboumatar
authors.forename: Bickey H
authors.initials: BH
authors.lastname: Chang
authors.forename: Jad
authors.initials: J
authors.lastname: Al Danaf
authors.forename: Mohammad
authors.initials: M
authors.lastname: Shaear
authors.forename: Ruth
authors.initials: R
authors.lastname: Namuyinga
authors.forename: Sathyanarayanan
authors.initials: S
authors.lastname: Elumalai
authors.forename: Jill A
authors.initials: JA
authors.lastname: Marsteller
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Pronovost
mesh_terms: D006761:Hospitals / Q000592:standards*; D006801:Humans; D017146:Models, Organizational; D017060:Patient Satisfaction; D018802:Patient-Centered Care / Q000592:standards*; D011787:Quality of Health Care; D014481:United States