Weinick Robin M, Quigley Denise D, Mayer Lauren A, Sellers Clarissa D
Jt Comm J Qual Patient Saf. 2014 Sep;40(9):418-27. doi: 10.1016/s1553-7250(14)40054-0.
The Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys are the standard for collecting information about patient experience of care in the United States. However, despite their widespread use, including in pay-for-performance and public reporting efforts and various provisions of the Affordable Care Act, knowledge about the use of CAHPS in assessing the impact of quality improvement efforts is limited. A study was conducted to examine the use of patient experience surveys in assessing the impact of innovations implemented in health care settings.
Innovation profiles identified on the Agency for Healthcare Research and Quality (AHRQ) Health Care Innovations Exchange website that included patient experience (including patient satisfaction) as an outcome (N = 201), were analyzed with a variety of qualitative analysis methods.
Fewer than half of the innovations used a patient experience measure, most commonly employing global measures such as an overall rating. Most innovations assessed patient experience at a single time point, with only one third using techniques such as pre-post comparisons, time trends, or comparisons to control groups. Ten domains of measures addressed reports of patient experience, all of which could be assessed by existing CAHPS instruments. Similarly, CAHPS measures are available to assess all of the organizational processes that are addressed by innovations in the profiles and for which patients are the best source of information. While 120 of the innovations that use patient experience measures report using surveys to collect these data, only 6 reported using a CAHPS measure.
Although innovations targeting quality improvement are often evaluated using surveys, there is considerable untapped potential for using CAHPS measures or surveys to assess their effectiveness.
医疗服务提供者与系统消费者评估（CAHPS）调查是美国收集患者就医体验信息的标准。然而，尽管它们被广泛使用，包括在绩效薪酬、公开报告工作以及《平价医疗法案》的各项条款中，但关于使用CAHPS评估质量改进工作影响的知识却很有限。开展了一项研究以检验患者体验调查在评估医疗机构实施的创新措施影响方面的应用情况。
对医疗保健研究与质量局（AHRQ）医疗保健创新交流网站上确定的创新概况进行分析，这些创新概况将患者体验（包括患者满意度）作为一项结果（N = 201），采用了多种定性分析方法。
不到一半的创新措施使用了患者体验指标，最常用的是总体评分等综合指标。大多数创新措施在单个时间点评估患者体验，只有三分之一的措施使用前后对比、时间趋势或与对照组对比等技术。有10个指标领域涉及患者体验报告，所有这些都可以通过现有的CAHPS工具进行评估。同样，CAHPS指标可用于评估概况中创新措施所涉及的所有组织流程，而患者是这些流程信息的最佳来源。虽然120项使用患者体验指标的创新措施报告称使用调查来收集这些数据，但只有6项报告使用了CAHPS指标。
尽管针对质量改进的创新措施通常使用调查进行评估，但使用CAHPS指标或调查来评估其有效性仍有相当大的未开发潜力。
