Identifying areas for improvement in paediatric inpatient care using the Child HCAHPS survey
Sadia Ahmed1,2, Kyle Kemp1, David Johnson2,3
1Department of Community Health Sciences, University of Calgary, Calgary, Alberta.
Insights
Improving pediatric inpatient care requires focusing on communication. The Child-Hospital Consumer Assessment of Healthcare Providers and Systems (Child-HCAHPS) survey reveals that nurse communication is key to overall patient experience.
Area of Science:
- Healthcare quality improvement
- Patient experience measurement
- Pediatric healthcare research
Background:
- The Child-Hospital Consumer Assessment of Healthcare Providers and Systems (Child-HCAHPS) survey is a validated tool for assessing pediatric inpatient experiences.
- Understanding which aspects of care most influence overall patient ratings is crucial for targeted quality improvement.
Purpose of the Study:
- To identify specific Child-HCAHPS survey questions most strongly correlated with parents' overall ratings of their child's inpatient care.
- To inform quality improvement initiatives by highlighting key drivers of patient satisfaction.
Main Methods:
- Conducted telephone surveys with 3,389 parents/guardians of children hospitalized for at least 24 hours.
- Analyzed 66 Likert-scale survey questions, correlating each with the overall care rating (0-10 scale) using Spearman correlation coefficients.
- Normalized all survey questions to a 100-point scale for analysis.
Main Results:
- Questions related to provider coordination and nursing care showed the strongest correlation with overall patient experience.
- The 'communication with nurses' domain exhibited the highest correlation (r=0.46, P<0.001).
- Factors like hospital room quietness and emergency room communication had poor correlations with overall experience.
Conclusions:
- This study, the first of its kind in a Canadian context, highlights the significant impact of communication on pediatric inpatient experience.
- Results suggest prioritizing personnel-based initiatives, particularly enhancing nurse communication, over physical hospital attributes for initial improvements.
- Focusing on communication with nurses can lead to significant gains in overall patient satisfaction.
Abstract:
The Child-Hospital Consumer Assessment of Healthcare Providers and Systems (Child-HCAHPS) survey is a validated measure of paediatric inpatient experience. The study objective was to determine which survey questions were most correlated with respondents' overall rating of care. Knowing which questions are most important may provide valuable insights for developing targeted quality improvement initiatives.
Methods:
Within 6 weeks of discharge, 3,389 telephone surveys were completed by parents/guardians of children who were hospitalized for at least 24 hours. The survey was comprised of 66 questions, with responses based on Likert-scales. One survey question asked respondents to rate the overall care that their child received on a scale from 0 (worst care) to 10 (best care). The correlation between the overall rating of care and each survey measure and question was then examined using Spearman correlation coefficients. All survey questions were normalized to a 100-point score (0=worst, 100=best).
Results:
Questions on provider coordination and nursing care were most correlated with overall experience. Quietness of hospital room (r=0.19, P<0.001), and keeping families informed in the emergency room (r=0.12, P<0.001) showed poor correlation. Correlation with overall experience was strongest for the 'communication with nurses' domain (r=0.46, P<0.001).
Conclusions:
To our knowledge, this is the first study which examines the correlation of individual questions of the Child-HCAHPS to overall rating of care within a Canadian context. Our results suggest that our large health care organization may attain initial inpatient experience improvements by focusing upon personnel-based initiatives, rather than physical attributes of our hospitals.
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