Patient Experience After Cardiac Surgery: Identifying Areas for Improvement

Area of Science:

• Cardiovascular Surgery
• Health Services Research
• Patient Experience

Background:

• Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys assess patient experience with inpatient care.
• HCAHPS data is publicly reported to evaluate healthcare quality.
• Assessing patient experience after cardiac surgery is crucial for identifying areas for practice improvement.

Purpose of the Study:

• To evaluate patient experiences following cardiac surgery using institutional HCAHPS data.
• To identify specific targets for quality improvement in cardiac surgery patient care.
• To analyze factors associated with patient ratings of hospital care.

Main Methods:

• Review of HCAHPS survey data from 1,315 patients undergoing common cardiac operations (Oct 2012-Sep 2015).
• Utilized top-box methodology for survey results and multivariable logistic regression to identify factors associated with low global ratings.
• Key driver analysis correlated global ratings with eight other domains to pinpoint quality improvement targets.

Main Results:

• Low global hospital ratings were linked to perceived poor overall health, younger age, prolonged hospital stay, and robotic mitral valve repair.
• Transcatheter aortic valve replacement (TAVR) outcomes were similar to open aortic valve operations.
• Key drivers influencing patient experience included care transitions and communication about medications.

Conclusions:

• Improving care transitions and medication communication are primary targets for enhancing patient experience in cardiac surgery.
• Less invasive procedures, such as robotic mitral valve repair and TAVR, were not independently associated with higher patient-reported experience scores.