The entire national quality infrastructure I described in my last column (CMS, JCAHO, AHRQ, NQF) began to work on adding experience to the suite of measurements being developed. In 2006, CMS introduced the HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) survey. This was a set of questions designed to be used at all hospitals nationwide, a significant development, because there was now a national standard for patient experience that could be compared over time and across hospitals anywhere in the country.2
In 2007, all hospitals subject to the Inpatient Prospective Payment System—pretty much all hospitals except critical access hospitals—were required to submit their HCAHPS survey data or face up to a 2% penalty. In 2008, this experience data was released publicly for the first time.2
And, of course, the Patient Protection and Affordable Care Act of 2010 (ACA) included HCAHPS results in calculating Hospital Value-Based Purchasing payments.3
The Institute of Medicine, in laying out a vision for better healthcare in 2012, called for more involvement of patients and families.
We are even seeing organizations creating leadership positions solely focused on patient experience. The Cleveland Clinic created the first physician leadership position dedicated to patient experience in the country, appointing Bridget Duffy, MD, a hospitalist, as its first chief experience officer in 2010. In 2012, Sound Physicians became the first hospitalist company to create such a position, to which it appointed Mark Rudolph, MD. Who would have imagined this 10 years ago?
Life for hospitalists has changed dramatically from the early 1990s to the Millenials now entering our workforce. The forces guiding our work and stimulating our growth have evolved, but the overarching theme of the last twenty years has been improvement. When the medical world took a cold hard look at the care being delivered, we suddenly saw a world of opportunities for improvement.
I talked before about how the rise of the patient safety and quality movement coincided perfectly with the emergence of hospitalists. Here I told you about how patient experience emerged in prominence as we, collectively, in becoming aware of our quality deficits, gained newfound empathy for what patients were going through. This focus on patient experience again plays into our strength and the opportunity we have as a specialty.
In the December issue of The Hospitalist, the final column in this five-part series will examine how to put it all together as we move toward the future of the field. But first I’ll introduce one last factor, a problem that helped launch our field and is now the greatest threat to our success.
Dr. Kealey is SHM president and medical director of hospital specialties at HealthPartners Medical Group in St. Paul, Minn.
References
- Press Ganey Associates, Inc. A spark ignited nearly three decades ago. Available at: http://www.pressganey.com/aboutUs/ourHistory.aspx. Accessed August 31, 2014.
- Centers for Medicare and Medicaid Services. HCAHPS Fact Sheet. Available at: www.hcahpsonline.org. Accessed August 31, 2014.
- American Hospital Association. Inpatient PPS. Available at: http://www.aha.org/advocacy-issues/medicare/ipps/index.shtml. Accessed August 31, 2014.