Bioethics Blogs

Worrying about patient satisfaction only harms the patient

by Craig Klugman, Ph.D.

Anyone who has been in a hospital in the last 9 years has encountered a patient satisfaction survey. This national survey provides rankings of hospitals based on how satisfied patients are with their experience. The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) “is a survey instrument and data collection methodology for measuring patients perceptions for their hospital experience.” For anyone who works in a hospital, the results of this survey can mean raises, firings, and changes of position.

The Centers for Medicaid & Medicare Services and the Agency for Healthcare Research and Quality developed this 27 question survey that has been administered to all hospital patients after discharge since 2006. The Deficit Reduction Act of 2005 requires hospitals to collect this information if they wish to receive their annual payments from CMS. Those with low ratings can lose funding and those who rank lowly on national and local scales are expected to make changes.

The first 20 questions ask discharged patient to choose on a Likert scale about their treatment with courtesy and respect; being listened to; clarity of explanations of treatments, procedures and drugs; help received when desired; cleanliness of facilities; ambient noise levels; pain control; understanding of discharge information. Two questions ask about comparing your hospital stay with previous stays and whether the patient “would recommend this hospital to your friends and family?” Patients are then asked a series of demographic questions. That’s it. There’s nothing about whether they were cured or treated. There was nothing about whether the physician was adequately trained.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.