Reprise: The Value of Patients’ Handwritten Comments on HCAHPS Surveys

Quantitative data used to gauge patient satisfaction is and has been the primary focus of healthcare systems.

In a recent study entitled “The Value of Patients’ Handwritten Comments on HCAHPS Surveys,” researchers make the case for the importance of qualitative data such as patient written comments that can add significant insight into the quality and nature of the patient experience of care and service.

For instance, the study’s authors share the following example to evidence how patient comments can shed light on the rationale behind a patient’s selection on a survey: “…One respondent in our study checked two answers to HCAHPS Question 2 (During this hospital stay, how often did nurses listen carefully to you?) and wrote the following explanation: DayNever; NightAlways. The HCAHPS scoring protocol calls for this patient’s response to be discarded and coded as missing data because the patient gave two answers to the same question (CMS, 2012). However, the patient’s response is genuine and offers an important insight, illustrating what Pavlou and Dimoka (2006, 398) term fine-grained information, which cannot be captured by numerical ratings, as the patient intended to give credit to the nurses who listened carefully and criticize those who did not.”

The authors concluded in their study that “the results show that patients’ anecdotal comments add to the prediction of overall hospital rating with and intention to recommend the hospital beyond the HCAHPS composite measures. This finding is consistent with the notion that ( 1 ) anecdotal feedback contains information that numerical ratings do not capture and (2) rating scales do not completely assess people’s experiences (Pavlou & Dimoka, 2006).” Ultimately, “…quantitative HCAHPS ratings understate the feelings of people who choose to report negative experiences and indicate that they are more dissatisfied than their responses to individual HCAHPS questions would indicate.”

To read the entire study, click here.


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