Using the H-CAHPS survey to ‘measure’ hospital inpatient experience in Alberta

IMAGINE is committed to working with our health system partners towards improved patient experience and outcomes. It is important for us to understand what strategies are currently being used in Alberta to assess patient experience.

We recently learned more about the H-CAHPS Survey that Alberta Health Services (AHS) is currently using to assess hospital inpatient experience across Alberta. We thought others would be interested in learning how data about Albertans’ hospital experiences is being collected and shared.

What is H-CAHPS?

H-CAHPS stands for Hospital-Consumer Assessment of Healthcare Providers and Systems, and was developed in the United States (U.S.) by the Agency for Healthcare Research and Quality (AHRQ). These survey questions were developed based on many focus groups with patients to learn about what was most important to them when they were in hospital. It was endorsed for widespread use in the U.S. in 2005 – following extensive field-testing. The former Calgary Health Region was one of the sites that participated in this field-testing back in 2004, in part to see whether the survey could be used in a Canadian context.

How is H-CAHPS being administered in Alberta?

In 2011 AHS expanded the use of H-CAHPS to assess adult inpatient experience in 93 hospitals across Alberta. A few additional questions of interest to AHS have been added to the standard H-CAHPS survey; so the survey being used here in Alberta contains 56 questions on the following topics:

  • Communication with nurses
  • Care Transition
  • Communication with doctors
  • Cleanliness of hospital
  • Responsiveness of hospital staff
  • Quietness of hospital
  • Pain management
  • Recommendation of hospital
  • Communication about medicines
  • Overall hospital rating
  • Discharge information
  • Patient complaints

This survey is conducted over the phone by AHS interviewers based in Calgary, and takes about 15 minutes to complete. 10% of patients discharged from each of these 93 hospitals are surveyed, meaning that each year more than 20,000 of these surveys are completed. In 2014-2015, the survey had a 76.8% response rate. That is, 76.8% of the patients that were reached by phone agreed to participate in the survey.

How is the information collected through the H-CAHPS survey being used?

The survey results are now reported to AHS staff at the province, zone, site and unit levels. The unit level data only became available in 2014. This means that individual in-patient units are now able to get their own patient experience data, and can use this data to improve the patient experience on their units.

What are some key findings from the survey, and how is the data being reported publicly?

Currently only one key measure from this survey is being reported on AHS’s public website, and that is overall satisfaction with hospital care. This is one of AHS’s 17 strategic performance measures which you can review here

IMAGINE is interested in learning more about the survey data that is not yet shared publicly. In future we hope that more data will be reported and shared with Albertans, similar to what is available for U.S. hospitals. If you are interested in seeing the U.S. H-CAHPS results you can find them here

IMAGINE would also like to learn more about some of the specific improvements that have been made in Alberta hospitals as a result of learnings from the H-CAHPS survey. If you are aware of any examples, please let us know!