Quality evaluations enhanced by patient feedback

From secret shoppers to sophisticated surveys, patient reports about their care experiences are providing insights for quality improvement.

By Kevin B. O'Reilly, AMNews staff. Jan. 16, 2006.

Hospitals that hire Barbara Gerber to show up in a wig and pose as a patient to thoroughly document how well they treat their patients are willing to pay a premium for the service -- up to $25,000 for dozens of incognito visits and a voluminous report from the president of the health care mystery shopping firm Devon Hill Associates.

The bill from the La Jolla, Calif.-based company represents a hospital's investment in discovering what only patients can tell them about the quality of care: Whether patients feel they are listened to, treated with respect and able to share in medical decision-making.

"There's an interpersonal quality to patient care," said Gerber, a former hospital marketing director. "If people don't like the physician or nurse, that may have some serious implications" for the quality of care.

Mystery patients aren't new to hospitals or even physicians' offices. But there's a renewed focus to make patient-reported experiences a critical part of quality evaluations.

Most recently, the National Quality Forum in December 2005 endorsed a 27-question survey that attempts to measure patients' experiences. The Agency for Healthcare Research and Quality developed the questionnaire, named Hospital Consumer Assessment of Healthcare Providers and Systems, or HCAHPS.

"There was some sense in the past that all patients cared about was the color of the walls and free parking," said Elaine J. Power, PhD, NQF's vice president of programs. Now, she said, hospitals and physicians appreciate that the core of a patient's health care experience can help quality improvement efforts.