Stakeholder input on the CAHPS ambulatory surveys

Area of Science:

• Healthcare quality improvement
• Patient experience research
• Health services research

Background:

• Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys are critical for evaluating patient healthcare experiences.
• Despite periodic updates, concerns about CAHPS survey content, length, and score distributions persist.
• Systematic stakeholder feedback is essential for refining CAHPS ambulatory surveys.

Purpose of the Study:

• To gather systematic stakeholder feedback to inform future revisions of CAHPS ambulatory surveys.
• To assess the essentialness of existing CAHPS survey item topics.
• To identify potential new topics for inclusion in CAHPS ambulatory surveys.

Main Methods:

• A modified Delphi method was used with a 20-member expert panel.
• Participants rated the essentialness of 46 existing item topics on a 1-9 scale over three phases.
• Reliability of ratings was assessed using a mixed-effects analysis of variance model.

Main Results:

• Expert rating reliability improved from initial to final rounds (ICC 0.08 to 0.10).
• Essentialness increased for digital access, medication reconciliation, provider communication, and appeals; decreased for specialist care and off-hours access.
• Key themes emphasized access, communication, respectful interactions, and cost clarity; new topics included mental health and patient safety.

Conclusions:

• Stakeholder input provides valuable insights for revising CAHPS ambulatory survey content.
• Revisions should enhance clarity and actionability of existing items and incorporate new topics reflecting current healthcare priorities.
• Expanded CAHPS surveys can offer more comprehensive assessments of ambulatory patient experiences.