Some Aspects of Patient Experience Assessed by Practices Undergoing Patient-Centered Medical Home Transformation Are Measured by CAHPS, Others Are Not.
Some Aspects of Patient Experience Assessed by Practices Undergoing Patient-Centered Medical Home Transformation Are Measured by CAHPS, Others Are Not.
复制标题
通过以患者为中心的医疗之家转型实践评估的患者体验的某些方面是由 CAHPS 衡量的，而其他方面则不是。
DOI：
10.1097/qmh.0000000000000263
复制
发表时间：
2020
影响因子：
1.2
通讯作者：
Hays,RonD
中科院分区：
文献类型：
--
作者：
Xenakis,Lea;Quigley,DeniseD;Qureshi,Nabeel;AlMasarweh,Luma;Pham,Chau;Hays,RonD
方法：我们从2008-2017年NCQA实践目录中随机选择实践，这些实践根据地区，医生数量，PCMH识别的年数和水平以及CG-CAHPS PCMH调查的使用申请PCMH识别。我们从了解实践的PCMH历史和患者经验数据的实践领导者那里收集实践的特征。我们确认了在其PCMH病史期间使用的患者经验调查，并要求提供其非CAHPS调查的副本。对于不执行建议的CG-CAHPS调查的实践（53/105实践），我们获得并编码了其非CAHPS调查的内容（68%; 36/53）。我们映射了患者的经验领域和具体措施的CG-CAHPS调查（版本2.0和3.0），CAHPS PCMH项目集（版本2.0和3.0），和可用的CG-CAHPS补充items.Results：无论是否管理的CG-CAHPS项目的做法，他们中的大多数都解决了主题包含在CG-CAHPS调查，如获得护理，供应商沟通，办公室工作人员的帮助/礼貌，护理协调，和共享决策。最常见的CAHPS措施包括办公室工作人员的乐于助人/有礼貌和提供者的沟通。常见的非CAHPS措施包括易于调度，被告知延迟，和供应商helpfulness/courteousness.Conclusion：NCQA PCMH做法包括CAHPS项目对他们的病人的经验调查，即使他们没有管理的完整的CG-CAHPS调查或推荐的CAHPS PCMH调查。为了提高患者经验调查对正在经历PCMH变化的实践的有用性，可以制定与PCMH变化的关键领域相关的额外CAHPS措施，包括扩大获得护理的机会（即，下班后和周末访视，易于安排，被告知延迟），使用共享决策，以及改善提供者沟通（即，提供者彬彬有礼，其他临床工作人员与患者沟通）。这些额外的措施将有助于实践领导者捕捉他们的PCMH转型的广度和深度及其对提供更多以患者为中心的护理的影响。开发这些项目将有助于规范PCMH转型期间与患者体验相关的变化的测量。需要进行研究，以确定CAHPS调查是否是这一信息的最佳来源。
Methods:We randomly selected practices from the 2008-2017 NCQA directory of practices that had applied for PCMH recognition based on region, physician count, number of years and level of PCMH recognition, and use of the CG-CAHPS PCMH survey. We collected characteristics of the practices from practice leader (s) knowledgeable about the practice's PCMH history and patient experience data. We confirmed the patient experience surveys used during their PCMH history and requested copies of their non-CAHPS survey (s). For practices not administering the recommended CG-CAHPS survey (53/105 practices), we obtained and coded the content of their non-CAHPS surveys (68%; 36/53). We mapped the patient experience domains and specific measures to the CG-CAHPS survey (versions 2.0 and 3.0), CAHPS PCMH item set (versions 2.0 and 3.0), and the available CG-CAHPS supplemental items.Results:Whether or not practices administered the CG-CAHPS items, most of them addressed topics contained in the CG-CAHPS survey such as Access to care, Provider communication, Office staff helpfulness/courteousness, Care coordination, and Shared decision-making. The most common CAHPS measures included were Office staff helpfulness/courteousness and Provider communication. Common non-CAHPS measures included were Ease of scheduling, Being informed about delays, and Provider helpfulness/courteousness.Conclusion:NCQA PCMH practices included CAHPS items on their patient experience surveys even if they did not administer the full CG-CAHPS survey or the recommended CAHPS PCMH survey. To enhance the usefulness of patient experience surveys for practices undergoing PCMH changes, additional CAHPS measures could be developed related to key areas of PCMH change, including expanded access to care (ie, after-hours and weekend visits, ease of scheduling, being informed about delays), use of shared decision-making, and improvements in provider communication (ie, the provider is courteous, communication by other clinical staff members with the patient). These additional measures would assist practice leaders in capturing the breadth and depth of their PCMH transformation and its influence on providing more patient-centered care. Developing such items would help standardize the measurement of changes related to patient experience during PCMH transformation. Research is needed to determine whether a CAHPS survey is the best source of this information.