title: Achieving a 5-star rating: Analysis of Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores among patients undergoing elective colorectal operations.
abstract: Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a publicly reported survey of patients' hospital experience.
  
  
  
  All inpatient, elective colorectal resections with completed HCAHPS surveys at a single institution between June 2012 and April 2015 were identified. HCAHPS measures were analyzed according to published methodologies. Univariate logistic regression evaluated associations of various HCAHPS measures with age, sex, ostomy, approach, diagnosis, and prolonged length of stay (PLOS; ≥7 days). Key driver analysis demonstrated associations between the individual HCAHPS measures and the global hospital rating measure.
  
  
  
  We identified 755 patients. Younger age, inflammatory bowel disease, open approach, ostomy construction, and PLOS were associated with low quality of pain management. Patients with inflammatory bowel disease, open approach, and PLOS had a low overall star score (all P < .05). Care transitions and communication about medications received low scores but were associated highly with the global hospital rating measure.
  
  
  
  Efforts aimed at improving pain management among patients with colorectal resection should focus on patients with inflammatory bowel disease, open operations, ostomies, and PLOS. Improving care transitions and communication about medications are important targets for improvement to increase the overall hospital score. Considering the importance of improving patient-centered outcomes, we suggest that all institutions utilize their existing HCAHPS data in this manner.
authors.affiliation: Department of Surgery, Mayo Clinic, Rochester, MN; Surgical Outcomes Program, The Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN.
authors.forename: Cornelius A
authors.initials: CA
authors.lastname: Thiels
authors.affiliation: Surgical Outcomes Program, The Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN.
authors.forename: Kristine T
authors.initials: KT
authors.lastname: Hanson
authors.affiliation: Surgical Outcomes Program, The Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN; Care Experience Program, Mayo Clinic, Rochester, MN.
authors.forename: Kathleen J
authors.initials: KJ
authors.lastname: Yost
authors.affiliation: Department of Surgery, Mayo Clinic, Rochester, MN.
authors.forename: Kellie L
authors.initials: KL
authors.lastname: Mathis
authors.affiliation: Department of Surgery, Mayo Clinic, Rochester, MN.
authors.forename: Robert R
authors.initials: RR
authors.lastname: Cima
authors.affiliation: Department of Surgery, Mayo Clinic, Rochester, MN.
authors.forename: Martin D
authors.initials: MD
authors.lastname: Zielinski
authors.affiliation: Surgical Outcomes Program, The Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN. Electronic address: Habermann.Elizabeth@mayo.edu.
authors.forename: Elizabeth B
authors.initials: EB
authors.lastname: Habermann
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D003107:Colorectal Surgery / Q000379:methods* / Q000401:mortality; D017558:Elective Surgical Procedures / Q000379:methods / Q000401:mortality; D005260:Female; D019538:Health Care Surveys; D006282:Health Personnel / Q000592:standards* / Q000639:trends; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D019984:Quality Indicators, Health Care; D011787:Quality of Health Care; D018570:Risk Assessment; D015996:Survival Rate; D016896:Treatment Outcome; D014481:United States