Update on CAHPS® Surveys AHRQ ANNUAL MEETING

Lunch and Learn Session #46SEPTEMBER 20, 2011

Judith Sangl, ScD

AHRQ CAHPS Project Officer

CAHPS® Program

• CAHPS = Consumer Assessment of Healthcare Providers and Systems

• Most widely used survey tools for assessing the patient’s experience with care

• Initiated and funded by AHRQ since 1995

• Endorsed by National Quality Forum (NQF)

• Consortium members include: AHRQ, CMS, RAND, Yale/Harvard, and Westat

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CAHPS

Obtain assessments from consumers of the quality of care that they receive in different settings which– Inform selection decisions– Identify areas where providers and

organizations can improve their services – Provide quality information to care

providers and other audiences

CAHPS Design Principles

Emphasis on patients– What patients value with respect to the setting of care– Aspects of care for which patients are the best or only

source of information– Extensive testing with patients and families

Reports and ratings about experiences Standardization

– Questionnaires, data collection protocols, analysis, reporting

Multiple versions for diverse populations– Adult; Child; English & Spanish versions

All CAHPS surveys and products are in the public domain.

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CAHPS Family of Surveys

• Integrated system of products and strategies– Ambulatory Care Surveys– Facility Surveys– Supplemental Item Sets– Custom items can be added

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CAHPS Core Questionnai

re Items

Supplemental Items

CAHPS Survey

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CAHPS Ambulatory Care Surveys

• Health Plan Surveys– Adult and child– Medicare, Medicaid & commercial– Managed care, FFS, PPO– NCQA version– Disenrollee

• Clinician & Group Surveys– Adult and child– Visit-based and past 12 months versions– Survey updates (version 2.0) released soon

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CAHPS Ambulatory Surveys, cont’d

Clinician & Group Surveys (cont.)• American Indian Survey • Surgical Care Survey

Other Ambulatory Surveys• Home Health Care Survey• ECHO Survey (Behavioral Health Care)• Dental Plan Survey

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CAHPS Facility Surveys

• Hospital Survey• In-Center Hemodialysis Survey• Nursing Home Surveys (endorsed by NQF in

March 2011)

– In-person interview for long-term residents– Recently discharged short-stay residents

• Time limited endorsement – being finalized– Residents’ family members

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CAHPS Supplemental Item Sets

Clinician & Group Survey Item Sets• Patient-Centered Medical Home • Health Literacy • Cultural Competence • Health Information Technology

Health Plan Item Sets• Children with Chronic Conditions• People with Mobility Impairments

Additional supplemental items available for:• Health Plan Survey • Clinician & Group Survey

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Patient-Centered Medical Home (PCMH) Set

• Designed as a supplemental item set for the CAHPS Clinician and Group Survey

• PCMH-specific topic areas covered: -Coordination of Care-Comprehensiveness-Shared decision-making-Whole person orientation-Self-management support

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Health Literacy Set

• Designed as a supplemental set of 29 items for the CAHPS Clinician & Group Survey

• Six main topic areas covered:– Communication with doctors and nurses– Communication about health

problems/concerns – Communication about medicines– Communication about tests– Communication about forms– Disease self-management

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Cultural Competence Domains

• Designed as a supplemental item set for the CAHPS Clinician & Group Survey

• 3 reporting composites– Doctors are polite and considerate– Doctors give advice on staying healthy– Doctors are caring and inspire trust

• Examples of other topics include – Equitable treatment– Language access– Overall ratings (trust, interpreter services)

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Health Information Technology Set

• Designed as a supplemental item set for the CAHPS Clinician & Group Survey

• 3 reporting composites– Getting timely answers to medical questions by

email– Helpfulness of provider’s use of computers

during a visit– Helpfulness of provider’s web site in giving you

information about your care and tests

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The CAHPS Database

• National repository of data for selected CAHPS surveys

• Two major applications:o Benchmarking to evaluate health system

performance and support quality improvemento Research on consumer assessments of quality

• Funded by AHRQ and administered by Westat through the CAHPS User Network

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CAHPS Database Components

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• CAHPS Health Plan Survey Database– 4.3 million records collected– 12 Annual Chartbooks (1998 – present)

• CAHPS Clinician & Group Survey Database– Just launched in May 2011

• CAHPS Hospital Survey Database– .8 million records collected– 3 Annual Chartbooks (2006 – 2008)

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CG-CAHPS Database Composition(as of December 2010)

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CG-CAHPS Version N of Practice Sites N of Respondents

Adult 12-month 4-pt 235 41,834

Adult 12-month 6-pt 339 180,588

Child 12-month 6-pt 52 4,883

Adult Visit 469 103,442

TOTALS 1,095 330,747

CG-CAHPS Online Reports(http://www.cahps.ahrq.gov)

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View Comparative Results

Download Reports

CAHPS Improvement Guide (updated Spring 2011)

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CAHPS User Support Services (FREE!)

• Survey Instruments and Instructions– https://www.cahps.ahrq.gov– Redesigned CAHPS web site launched fall

2011 • CAHPS Technical support

– E-mail: CAHPS1@ahrq.gov– Phone: 800-492-9261

• CAHPS Database Technical support– E-mail: NCBD1@ahrq.gov– Phone: 888-808-7108

• Sign up for CAHPS listserv for latest updates

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Additional QI Resources

• CAHPS Improving Quality site: http://www.cahps.ahrq.gov

– Case studies of QI initiatives

– Supplemental survey questions

– Archived Webcasts and presentations

– Links to related resources

– - podcast series on quality improvement – released soon

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