On this page:
- What are the 29 HCAHPS Questions?
- What does the HCAHPS Survey Look For?
- What is the HCAHPS Survey?
- What is the Purpose of the HCAHPS Survey?
- When did Hospitals Begin to Use the HCAHPS Survey?
- How is the HCAHPS Survey Administered?
- Who is Eligible to Take the HCAHPS Survey?
- When do Patients Take the Survey?
- What Can Hospitals do to Improve HCAHPS Survey Scores?
- What Does CG CAHPS Stand For?
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Your Care from Nurses
- During this hospital stay, how often did nurses treat you with courtesy and respect?
- During this hospital stay, how often did nurses listen carefully to you?
- During this hospital stay, how often did nurses explain things in a way you could understand?
- During this hospital stay, after you pressed the call button, how often did you get help as soon as you wanted it?
Your Care from Doctors
- During this hospital stay, how often did doctors treat you with courtesy and respect?
- During this hospital stay, how often did doctors listen carefully to you?
- During this hospital stay, how often did doctors explain things in a way you could understand?
The Hospital Environment
- During this hospital stay, how often were your room and bathroom kept clean?
- During this hospital stay, how often was the area around your room quiet at night?
Your Experiences in This Hospital
- During this hospital stay, did you need help from nurses or other hospital staff in getting to the bathroom or in using a bedpan?
- How often did you get help in getting to the bathroom or in using a bedpan as soon as you wanted?
- During this hospital stay, were you given any medicine that you had not taken before?
- Before giving you any new medicine, how often did hospital staff tell you what the medicine was for?
- Before giving you any new medicine, how often did hospital staff describe possible side effects in a way you could understand?
When You Left the Hospital
- After you left the hospital, did you go directly to your own home, to someone else’s home, or to another health facility?
- During this hospital stay, did doctors, nurses or other hospital staff talk with you about whether you would have the help you needed when you left the hospital?
- During this hospital stay, did you get information in writing about what symptoms or health problems to look out for after you left the hospital?
Overall Rating of the Hospital
- Using any number from 0 to 10, where 0 is the worst hospital possible and 10 is the best hospital possible, what number would you use to rate this hospital during your stay?
- Would you recommend this hospital to your friends and family?
Understanding Your Care
- During this hospital stay, staff took my preferences and those of my family or caregiver into account in deciding what my health care needs would be when I left.
- When I left the hospital, I had a good understanding of the things I was responsible for in managing my health.
- When I left the hospital, I clearly understood the purpose for taking each of my medications.
About You
- During this hospital stay, were you admitted to this hospital through the Emergency Room?
- In general, how would you rate your overall health?
- In general, how would you rate your overall mental or emotional health?
- What is the highest grade or level of school that you have completed?
- Are you of Spanish, Hispanic or Latino origin or descent?
- What is your race? Please choose one or more.
- What language do you mainly speak at home?
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The Hospital Consumer Assessment of Healthcare Providers and Systems Survey, or HCAHPS, has been employed since 2006 to measure the perspectives of patients treated in hospitals across the nation. Also referred to as the CAHPS Survey, it is the first standardized and publicly reported survey of its kind to be used on a national level.
Pronounced “H-caps”, the HCAHPS Survey was developed by the Centers for Medicare & Medicaid Services (CMS) and the Agency for Healthcare Research and Quality (AHRQ). While the questions in the HCAHPS Survey may seem simple and straightforward on the surface, they were actually developed using the highest scientific standards over a multi-step process. In the development of the questionnaire, the government agencies employed a review of the literature available at the time, consumer testing, cognitive interviews, focus groups, input from stakeholders, a sizable field test, and multiple field tests.
Before implementation, the HCAHPS Survey was endorsed by a wide range of institutions and organizations, including consumer groups, healthcare providers, Federal agencies, professional associations, purchasers and research organizations.
The written version of the HCAHPS Survey is currently available in English, Spanish, Russian, Vietnamese and Chinese. The telephone and IVR versions are available in English and Spanish.
The HCAHPS Survey can be administered in four different ways, depending on the needs of the hospital and the patients. These options include:
Most patients who stay at a hospital are eligible to take the survey, although there are some exceptions. The specific requirements for participation include:
- The patient must be at least 18 years old at the time of admission to the hospital
- The patient must have a non-psychiatric MS-DRG/principal diagnosis at the time of discharge
- The patient must have stayed at least one full night at the hospital
- The patient must be alive at the time he/she is discharged from the hospital
While the HCAHPS Project Team designed the survey to gather information from as wide a spectrum of patients as possible, but there are limitations to the survey that must be accounted for – which is why some patients are ineligible to participate. For instance, the survey was not designed for pediatric patients or patients who have been diagnosed with behavioral health issues. Patients who only came into the hospital for a short period of time – those that did not stay overnight – are also excluded because they have not had enough interaction with the hospital staff to be considered in the overall survey.
To meet the needs of the survey requires not only that the patient has stayed at the hospital and received care, it also requires that the patient be accessible after discharge to take the survey. Some other patients are ineligible to participate in the survey because collecting information from them would prove too difficult to be practical. These ineligible patients include:
- Patients who have a home address outside of the United States
- Patients who have been discharged to hospice care
- Patients who have been discharged to specialized care facilities, such as nursing homes
- Patients who are prisoners
The HCAHPS Survey cannot be administered while the patient is still in the hospital. The patient to be sampled must participate in the survey within 48 hours to six weeks following discharge. The mode of the survey, whether by mail, telephone or another option, must be completed within the 48-hour to six week time period. If the survey is mailed out, the data must be collected within the six week time period to be admissible.
When the first HCAHPS Surveys were completed and the results were in, many hospitals were faced with an unpleasant shock – they did not score well, much worse than they expected to. Fortunately, by learning ways to deliver a better experience to patients, many of these hospitals were able to improve their scores over time. The surveys had accomplished one of the main goals of the HCAHPS Project Team, bringing transparency and encouraging improvement by medical providers.
Hospitals and hospital staff can learn to produce a patient experience that meets the requirements of the HCAHPS Survey. Once hospital staff understands that a positive patient experience requires more than just maintaining the standard of care – that patients want and need to be cared for as a person – then it becomes easier to design a system of care that accounts for HCAHPS Survey questions.
It is surprising for many hospitals to discover that patients generally expected the quality of the medical care provided by the hospital to be good. What patients were less certain of was whether their doctor, nurse or another medical provider would listen to them and genuinely care about how they felt. When hospitals begin to account for the way the patient feels on a personal level, raising the HCAHPS Survey scores becomes much easier to accomplish.
The Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CG CAHPS) is the version of the CAHPS designed for use in doctors’ offices. Where the HCAHPS Survey is used throughout hospitals, the CG CAHPS covers patients who are getting treatment in private practices. The survey is available in an adult version and a version for children – patients 17 and under. The CG CAHPS also varies from the HCAHPS in other ways, including the fact that it is available in multiple versions.
Versions of the CG CAHPS include:
The CG CAHPS is, much like the HCAHPS Survey, designed to measure a variety of factors in the patient’s experience with his or her medical providers. However, there are some differences. The CG CAHPS was created to gather data specific to visiting the doctor’s office, and includes questions about:
- Provider communication with the patient
- The ability of the patient to get an appointment when needed
- How well the patient was able to get important information regarding his or her medical care
- How well the provider used available information to coordinate the care of the patient
- The way the patient was treated by support staff – measuring courtesy, respectfulness, and politeness
- The overall rating that the patient gives the medical provider
The CG CAHPS survey forms are all available for download on the U.S. Department of Health and Services Agency for Healthcare Research and Quality website.
CG CAHPS – Transparency for Patients
The CG CAHPS serves a similar purpose to the HCAHPS Survey, allowing patients to get a clear picture of the experience of previous patients. With survey information made public on a regular basis, the public can make informed decisions about doctors, practices and medical groups. The doctor’s office surveys are also designed to improve the care that non-hospital medical providers offer the public. Transparency results in accountability and medical providers are given the opportunity to improve based on honest feedback from patients.
Our training library includes 42 videos to improve patient experience and HCAHPS scores through patient-centered training.
Training your staff on effective communication, active listening, empathy, setting realistic patient expectations, and exceeding those expectations will not only help significantly improve HCAHPS scores but will assist in creating a patient-centered culture.
