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Measure Summary
Title
Hospice services satisfaction: mean section score for "Arranging Hospice Care" questions on Hospice Services Survey.
Source(s)
Hospice services survey. South Bend (IN): Press Ganey Associates, Inc.; 2004. 4 p.

Measure Domain

Primary Measure Domain
Clinical Quality Measures: Patient Experience
Secondary Measure Domain
Does not apply to this measure

Brief Abstract

Description

This measure is used to assess the mean score for the questions in the "Arranging Hospice Care" section of the Hospice Services Survey.

The "Arranging Hospice Care" section is one of five sections that comprise the Hospice Services Survey. Mean section scores are reported for each section of the survey. In addition, an "Overall Facility Rating" score is reported.

Rationale
  1. Patient satisfaction is both an indicator of quality of care, and a component of quality care.

    In 2001, the Institute of Medicine (IOM) advocated a patient-centered model of care (Crossing the Quality Chasm: A New Health System for the 21st Century). In part, this is a reflection of the growing understanding that

    "...patients constantly judge the motives and competence of caregivers through their interaction with them. This judgment is a very personal one, based on perceptions of care being responsive to patients' "individual needs," rather than to any universal code of standards (McGlynn, 1997). When these individual needs are perceived as being met, better care results. Lohr (1997) notes: "Inferior care results when health professionals lack full mastery of their clinical areas or cannot communicate effectively and compassionately." In short, when patients perceive motives, communication, empathy, and clinical judgment positively, they will respond more positively to care...Sobel (1995) claims that improved communication and interaction between caregiver and patient improves actual outcome. Donabedian (1988, 1744) notes that "...the interpersonal process is the vehicle by which technical care is implemented and on which its success depends" (from Press [2002] Patient Satisfaction: Defining, Measuring, and Improving the Experience of Care, Health Administration Press).

    It is clear that patients quite actively evaluate what is happening to them during the experience of care. The degree to which the patient judges the care experience as satisfactory "...is not only an indicator of the quality of care, but a component of quality care, as well" (Press, 2002).

    Patient Satisfaction has been linked to the following clinical outcomes: Clinical Quality (e.g., Hemoglobin A1c levels, cholesterol levels, lower bed disability days); Chronic Disease Control; Compliance; Drug Complications; Quality of Life; Emotional Health Status; Mental Health; Physical Functioning; Physical Health Status; Post-Surgery Complications; Post-Surgery Recovery Times; Risk-Adjusted Mortality Rates; Unexpected Mortality; and Work Effectiveness (Clark, Drain, Malone, 2004).

  2. In addition to its connection to quality of care and clinical outcomes, Patient Satisfaction has been linked to the following:
    • Topline (Revenue): Loyalty; Volume; Physician Satisfaction; Patient's Trust in Provider; Retention; Employee Satisfaction
    • Bottomline (Expenses): Reduction in Expenses; Reduction in Length of Stay; Reduction in Complaints; Reduction in Malpractice Claims; Direct Measures of Financial Performance (e.g., bond rating, core margin, earnings per adjusted admission, market share, net margin, profit margin) (Clark, Drain, Malone, 2004)
Primary Health Components

Hospice services satisfaction

Denominator Description

Family members of patients in hospice care during the reporting period who answered at least one question in the "Arranging Hospice Care" section of the Hospice Services Survey

Numerator Description

The mean of all the family members' scores for the questions from the "Arranging Hospice Care" section of the Hospice Services Survey

Refer to the "Press Ganey's Hospice Services Survey: Calculation of Scores Information" document listed in the "Companion Documents" field for additional details.

Evidence Supporting the Measure

Type of Evidence Supporting the Criterion of Quality for the Measure
  • A formal consensus procedure, involving experts in relevant clinical, methodological, public health and organizational sciences
  • A systematic review of the clinical research literature (e.g., Cochrane Review)
  • Focus groups
  • One or more research studies published in a National Library of Medicine (NLM) indexed, peer-reviewed journal
Additional Information Supporting Need for the Measure

Unspecified

Extent of Measure Testing

The results of the psychometric analysis of test data indicated that the questionnaire has a high degree of validity and reliability. Construct validity was investigated using factor analysis. Principle Component factor analysis with oblique rotation identified six factors that accounted for 66% of the total variance. These factors generally paralleled the structure of subscales of the questionnaire. However, three separate factors emerged for the Hospice team section: nursing care, aide care, and care provided by other hospice workers. Because the nature of hospice care emphasizes a team approach, these factors will remain grouped together as a single subscale.

Predictive validity was investigated by determining the degree to which each survey item was able to predict the family members' likelihood to recommend hospice services. This outcome measure was chosen because satisfaction literature defines positive word of mouth (recommending to friends and family) as a behavioral outcome of satisfaction. A series of simple regression analyses revealed that each of the individual items are significant predictors (at the .01 level) of patients' reported likelihood to recommend the hospice services (betas ranged between .21 and .86). The questionnaire's reliability was examined using Cronbach's alpha. All five of the revised scales exceeded the stringent .70 standard for reliable measures. Reliability estimates for the sections range from .91 to .97. The Cronbach alpha for the entire questionnaire is .98, confirming the instrument's high internal consistency and reliability.

Evidence for Extent of Measure Testing
Hospice care family survey psychometrics. South Bend (IN): Press Ganey Associates, Inc.; 5 p.

Miceli PJ, Mylod DE. Satisfaction of families using end-of-life care: current successes and challenges in the hospice industry. Am J Hosp Palliat Care. 2003 Sep-Oct;20(5):360-70. PubMed External Web Site Policy

Mylod DE. Press, Ganey's commitment to hospice care. In: Satisfaction monitor. South Bend (IN): Press Ganey; 2000 Mar-Apr. p. 8.

State of Use of the Measure

State of Use
Current routine use
Current Use
Internal quality improvement

Application of the Measure in its Current Use

Measurement Setting
Hospices
Professionals Involved in Delivery of Health Services
Does not apply to this measure (e.g., measure is not provider specific)
Least Aggregated Level of Services Delivery Addressed
Single Health Care Delivery or Public Health Organizations
Statement of Acceptable Minimum Sample Size
Unspecified
Target Population Age

Unspecified

Target Population Gender
Either male or female

National Strategy for Quality Improvement in Health Care

National Quality Strategy Aim
Better Care
National Quality Strategy Priority
Person- and Family-centered Care

Institute of Medicine (IOM) National Health Care Quality Report Categories

IOM Care Need
End of Life Care
IOM Domain
Patient-centeredness

Data Collection for the Measure

Case Finding Period

The reporting period

Denominator Sampling Frame
Patients associated with provider
Denominator (Index) Event or Characteristic
Institutionalization
Denominator Time Window
Does not apply to this measure
Denominator Inclusions/Exclusions

Inclusions
Family members of patients in hospice care during the reporting period who answered at least one question in the "Arranging Hospice Care" section of the Hospice Services Survey

Exclusions
Unspecified

Exclusions/Exceptions
Does not apply to this measure
Numerator Inclusions/Exclusions

Inclusions
The mean of all the family members' scores for the questions from the "Arranging Hospice Care" section of the Hospice Services Survey

Refer to the "Press Ganey's Hospice Services Survey: Calculation of Scores Information" document listed in the "Companion Documents" field for additional details.

Exclusions
Unspecified

Numerator Search Strategy
Fixed time period or point in time
Data Source
Administrative clinical data
Patient/Individual survey
Type of Health State
Does not apply to this measure
Instruments Used and/or Associated with the Measure

Hospice Services Survey

Computation of the Measure

Measure Specifies Disaggregation
Does not apply to this measure
Scoring
Composite/Scale
Mean/Median
Interpretation of Score
Desired value is a higher score
Allowance for Patient or Population Factors
Analysis by subgroup (stratification by individual factors, geographic factors, etc.)
Description of Allowance for Patient or Population Factors

Data may be reported out separately for various kinds of patient groups at the client's request.

Standard of Comparison
External comparison of time trends
Internal time comparison

Identifying Information

Original Title

Hospice Services Survey, Arranging Hospice Care.

Submitter
Press Ganey Associates, Inc. - For Profit Organization
Developer
Press Ganey Associates, Inc. - For Profit Organization
Funding Source(s)

Press Ganey Associates, Inc.

Composition of the Group that Developed the Measure

Patients, providers, administrators, existing clients, Press Ganey Associates, Inc. employees

Financial Disclosures/Other Potential Conflicts of Interest

None known

Adaptation

This measure was not adapted from another source.

Date of Most Current Version in NQMC
2003 Jan
Measure Maintenance

Unspecified

Date of Next Anticipated Revision

Unspecified

Measure Status

This is the current release of the measure.

The measure developer reaffirmed the currency of this measure in March 2013.

Source(s)
Hospice services survey. South Bend (IN): Press Ganey Associates, Inc.; 2004. 4 p.
Measure Availability

The individual measure, "Hospice Services Survey, Arranging Hospice Care," is published in the "Hospice Services Survey."

For further information, contact: Press Ganey, 404 Columbia Place, South Bend, Indiana 46601; telephone: 800-232-8032; fax: 574-232-3485; e-mail: rwolosin@pressganey.com; Web site: www.pressganey.com External Web Site Policy.

Companion Documents

The following is available:

  • Press Ganey's hospice services survey: calculation of scores information. South Bend (IN): Press Ganey Associates; 2 p.

For further information, contact: Press Ganey, 404 Columbia Place, South Bend, Indiana 46601; telephone: 800-232-8032; fax: 574-232-3485; e-mail: rwolosin@pressganey.com; Web site: www.pressganey.com External Web Site Policy.

NQMC Status

This NQMC summary was completed by ECRI on March 24, 2006. The information was verified by the measure developer on April 3, 2006. This NQMC summary was retrofitted into the new template on July 8, 2011. The information was reaffirmed by the measure developer on March 25, 2013.

Copyright Statement

© PRESS GANEY ASSOCIATES, INC. All Rights Reserved

All inquiries regarding the measure should be directed to the Press Ganey Web site External Web Site Policy or e-mail Robert Wolosin, Ph.D. at rwolosin@pressganey.com.

Disclaimer

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