Are you educating your field staff on the content of the HHCAHPS Survey, with focus on the specific questions that impact outcome calculations?  Most of you would say, NO! 

HHCAHPS is of vital importance in the Home Health Value-Based Purchasing Expansion and when reviewing the initial Pre-Implementation Performance Reports (PIPR), many agencies are discovering they have great scores with all OASIS items, but are struggling in the HHCAHPS scores. 

Agencies must ensure that field staff understand the language used in the HHCAHPS surveys so they can use this wording in communicating with patients so that the patients accurately respond to the HHCAHPS Survey questions.  

Example:  One of the questions on the HHCAHPS asks “..when you contacted this agency’s office did you get the help or advice you needed?”  In most cases a patient calling your office is not going to use the terms ‘help’ or ‘advice’.  It’s important to be aware of the language being used when communicating with them.  Using statements, when in their home, such as, “If there’s ever anything we can HELP you with, please don’t hesitate to call us first.” Such phrasing encourages the patient to call the home health agency for assistance instead of automatically going straight to the emergency room or calling 911 in a panic.  Connecting this to the HHCAHPS means that when reading the question about calling for HELP, they will connect that calls they make to you are when they need HELP or ADVICE. 

Another Example:   The question regarding whether the agency talked with the patient about setting their home up safely does not seem to resonate with patients.  Recently a therapist taught a patient to use a walker when ambulating and to remove loose rugs to prevent falls. After three sessions of this repeated education, the therapist asked the patient if they felt they had covered safety effectively, but the patient said no. I asked the therapist if they had used the word “safety” when instructing the patient, and the therapist didn’t understand. I emphasized that the therapist should have explicitly said, “When you ambulate, you need to ensure your safety by using your walker” and “make sure for your safety that there are no loose rugs on the floor so you don’t trip and fall.”   

When working with patients on safety measures it is important to use terms such as “safety” instead of simply speaking generally about avoiding falls or other associated risks of not following instructions correctly; this will provide further clarity and help trigger their knowledge of survey questions regarding safety issues related to care provided by home care staff.   

It is essential for home care providers and staff to have an understanding of what is being asked in survey questions so they can improve communication with their patients.  To increase knowledge in this area, it is imperative that clinicians review survey questions included in the five outcome measure calculations for Value-Based Purchasing; this way, they will know exactly what language should be utilized when talking with their patients about certain topics or issues related to care received from home care providers.   

Overall, understanding HHCAHPS language and incorporating it into daily conversations between home care providers and their patients is essential if quality outcomes are going to be documented consistently over time. Utilizing terms like “help” or “safety” while speaking with patients will assist patients in more accurately answering survey questions related to receiving care from home care providers; this will contribute greatly towards making sure accurate data is being provided so agencies can experience the outcome scores that most reflect the actual care they are providing, which impact the HHCAHPS Star Rating and Value-Based Purchasing scores.   

If any additional assistance is needed regarding HHCAHPS surveys and how best to communicate with patients about certain topics, home care providers should not hesitate reach out and ask for help from Healthcare Provider Solutions.  

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