The Home Health Consumer Assessment of Healthcare Providers and Systems (HHCAHPS) patient engagement survey impacts the bottom line of home health agencies (HHAs) primarily through attracting referral sources and value-based reimbursement.  It is imperative for organizations to understand the HHCAHPS survey, and work on improving each measure for maximizing their organizations long-term growth and sustainability.

Care of Patients – Question 16

The question determining the frequency of care in the last two months is found in the Care of Patients domain as question 16, and is one of four questions on this subject in the Home Health CAHPS survey. The following can be reviewed during a staff meeting by ensuring all team members understand the question and how to discuss and interact with patients.

This question seeks to assess the frequency of treatment and the perception of the patient as to whether or not they were treated gently. Gentleness is not easily taught, but rather a heightened awareness on the part of the healthcare provider about how their non-verbal and verbal actions are perceived by patients.  The ability of the providers to compassionately interact with the patient during visits will help improve this assessment.

Potential Interventions to Improve

• Introduce themselves to the patient and family as the clinician when receiving a call in the office, or when arriving at their home.
• Assess the state of the patient when arriving in their home and acknowledging, through active listening skills, empathy for their state of mind.
• Initiate care and inform the patient and their family of the reason for the visit and explain their contribution to the plan of care.
• Inform the patient of assessments, exams or procedures to be conducted prior to initiating any activity.
• Remember to acknowledge procedures that may be uncomfortable or unpleasant, while seeking to project confidence and letting them know the care provider will seek to minimize pain (e.g. warming hands prior to touching bare skin).
• Educate a patient receiving physical therapy ahead of time to take their pain medication to minimize the pain they may experience in treatment, and communicate they are being treated as gently as possible.
• Increase awareness of how the patient is approached, posture and patient interactions during the course of providing patient care.

A recent study examining gentleness found the most important aspect to be “a soft and slow approach.”  This approach included a wide range of behaviors, such as speaking in a soft and quiet manner; softly touching hands or the lower arm; keeping an open posture (i.e. not crossing arms); sitting or crouching down to talk with clients;  and generally not rushing care delivery or decisions.

These behaviors should be reinforced with clinician teams to continue providing patient-centered care and improving the quality of care provided to patients.  According to the study, the goal for HHAs is to build a culture where everyone remembers to “be kind and gentle, for everyone [they] meet is fighting a difficult battle,” and treat patients gently.

Check our blogs for the series on improving your agency’s HHCAHPS scores by systematically reviewing each of the HHCAHPS questions, and sharing opportunities for improvement.