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J Hosp Med. 2017 Jun;12(6):421-427. doi: 10.12788/jhm.2743.

Do HCAHPS Doctor Communication Scores Reflect the Communication Skills of the Attending on Record? A Cautionary Tale from a Tertiary-Care Medical Service.

Author information

1
Department of Hospital Medicine, Medicine Institute, Center for Excellence in Healthcare Communication, Office of Patient Experience, Cleveland Clinic, Cleveland, Ohio.
2
Department of Hospital Medicine, Medicine Institute, Department of Outcomes Research, Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio.
3
Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio.
4
Indiana University School of Medicine, Cleveland Clinic Education Institute, Cleveland, Ohio.
5
Center for Excellence in Healthcare Communication, Office of Patient Experience, Cleveland Clinic, Cleveland, Ohio.
6
Office of Patient Experience, Cleveland Clinic, Cleveland, Ohio.
7
Office of Patient Experience, Lerner College of Medicine, Cleveland Clinic, Cleveland, Ohio.
8
Center for Value-based Care Research, Cleveland Clinic Medicine Institute, Cleveland Clinic, Cleveland, Ohio.

Abstract

BACKGROUND:

Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores measure patient satisfaction with hospital care. It is not known if these reflect the communication skills of the attending physician on record. The Four Habits Coding Scheme (4HCS) is a validated instrument that measures bedside physician communication skills according to 4 habits, namely: investing in the beginning, eliciting the patient's perspective, demonstrating empathy, and investing in the end.

OBJECTIVE:

To investigate whether the 4HCS correlates with provider HCAHPS scores.

METHODS:

Using a cross-sectional design, consenting hospitalist physicians (n = 28), were observed on inpatient rounds during 3 separate encounters. We compared hospitalists' 4HCS scores with their doctor communication HCAHPS scores to assess the degree to which these correlated with inpatient physician communication skills. We performed sensitivity analysis excluding scores returned by patients cared for by more than 1 hospitalist.

RESULTS:

A total of 1003 HCAHPS survey responses were available. Pearson correlation between 4HCS and doctor communication scores was not significant, at 0.098 (-0.285, 0.455; P = 0.619). Also, no significant correlations were found between each habit and HCAHPS. When including only scores attributable to 1 hospitalist, Pearson correlation between the empathy habit and the HCAHPS respect score was 0.515 (0.176, 0.745; P = 0.005). Between empathy and overall doctor communication, it was 0.442 (0.082, 0.7; P = 0.019).

CONCLUSION:

Attending-of-record HCAHPS scores do not correlate with 4HCS. After excluding patients cared for by more than 1 hospitalist, demonstrating empathy did correlate with the doctor communication and respect HCAHPS scores. Journal of Hospital Medicine 2017;12:421-427.

PMID:
28574531
DOI:
10.12788/jhm.2743
[Indexed for MEDLINE]

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