Use of CAHPS^® patient experience survey data as part of a patient-centered medical home quality improvement initiative

Abstract

Objective

To describe how practice leaders used Consumer Assessment of Healthcare Providers and Systems (CAHPS^®) Clinician and Group (CG-CAHPS) data in transitioning toward a patient-centered medical home (PCMH).

Study design

Interviews conducted at 14 primary care practices within a large urban Federally Qualified Health Center in California.

Participants

Thirty-eight interviews were conducted with lead physicians (n=13), site clinic administrators (n=13), nurse supervisors (n=10), and executive leadership (n=2).

Results

Seven themes were identified on how practice leaders used CG-CAHPS data for PCMH transformation. CAHPS^® was used: 1) for quality improvement (QI) and focusing changes for PCMH transformation; 2) to maintain focus on patient experience; 3) alongside other data; 4) for monitoring site-level trends and changes; 5) to identify, analyze, and monitor areas for improvement; 6) for provider-level performance monitoring and individual coaching within a transparent environment of accountability; and 7) for PCMH transformation, but changes to instrument length, reading level, and the wording of specific items were suggested.

Conclusion

Practice leaders used CG-CAHPS data to implement QI, develop a shared vision, and coach providers and staff on performance. They described how CAHPS^® helped to improve the patient experience in the PCMH model, including access to routine and urgent care, wait times, provider spending enough time and listening carefully, and courteousness of staff. Regular reporting, reviewing, and discussing of patient-experience data alongside other clinical quality and productivity measures at multilevels of the organization was critical in maximizing the use of CAHPS^® data as PCMH changes were made. In sum, this study found that a system-wide accountability and data-monitoring structure relying on a standardized and actionable patient-experience survey, such as CG-CAHPS, is key to supporting the continuous QI needed for moving beyond formal PCMH recognition to maximizing primary care medical home transformation.

Keywords:

• PCMH
• performance improvement
• accountability
• CAHPS^®

Acknowledgments

Preparation of this manuscript was supported through a cooperative agreement from the Agency for Healthcare Quality (contract number U18 HS016980).

Disclosure

The authors report no conflicts of interest in this work.