Development of the Revised CAHPS Hospice Survey

Area of Science:

• Health Services Research
• Quality Improvement
• Patient-Centered Care

Background:

• The CAHPS Hospice Survey is mandatory for the Centers for Medicare & Medicaid Services (CMS) Hospice Quality Reporting Program.
• Over 4,000 hospices administer the survey monthly.
• Revisions were made to shorten, simplify, and add content on care preferences and cultural needs.

Purpose of the Study:

• To detail the development process of the revised CAHPS Hospice Survey instrument.
• To incorporate stakeholder feedback into the survey design.
• To enhance the assessment of patient care preferences and cultural needs.

Main Methods:

• Conducted a plain language review and environmental scan.
• Refined existing survey wording and drafted new items.
• Performed 7 rounds of cognitive interviews with 59 family caregivers.

Main Results:

• Caregivers understood concepts like "respecting wishes" and "listening to what matters most."
• Phrases such as "cultural practices" and "choosing what to do next" were found to be confusing.
• Incorporating "cultural beliefs" improved assessment of non-religious traditions; symptom and training measures were consolidated.

Conclusions:

• The revised CAHPS Hospice Survey effectively balances the addition of stakeholder-prioritized topics with reduced survey complexity.
• The updated instrument aims to improve the quality and relevance of hospice care reporting.