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Improving Home Health CAHPS Results: Care of Patients – Courtesy and Respect

The Home Health Consumer Assessment of Healthcare Providers and Systems (CAHPS) patient engagement survey impacts the bottom line of home health agencies, primarily through attracting referral sources and value based reimbursement.  It is imperative for organizations to understand the Home Health CAHPS survey and work on improving each measure for maximizing their organizations long term growth and sustainability.  The following can be reviewed during a staff meeting by ensuring all team members understand the question and how to discuss it with patients.

Courtesy and Respect – Question 19

We are reviewing question 19 in the Care of Patients domain, with the answers and opportunities for improvement. It is part of the Care of Patient domain and one of four other questions from the Home Health CAHPS survey, and can be found in the table below with the allowable responses. These questions are directed at determining how patients feel about the care they received from the agency during the previous two months.

This question seeks to assess the perception of the patient on whether they were treated with courtesy and respect.  Although courtesy and respect may be interpreted differently by each patient, understanding their personal preferences is an excellent starting pointing for ensuring we acknowledge and address them throughout our interactions with them.  Our ability to interact with patients with universally accepted etiquette during visits and over the phone will assist in improving this aspect of care.

Potential Interventions to Improve

  • Capturing patient cultural and personal preferences and making key preferences available in an easily retrievable section of patient records
  • Determining how patients prefer to be addressed (Mr, Mrs, Dr, Ms, etc.) and documenting responses for use by other staff during subsequent visits
  • Staff introducing themselves to the patient and family when making or receiving a call from them in the office, or when arriving at their home
  • Training staff on self-awareness and use of non-verbal cues such as smiling, position of arms, voice tone and inflection during patient interactions, and the messages they convey
  • Encouraging staff to introduce themselves to the patient and family when arriving at their home or on the phone
  • Requesting patient preferences for home etiquette such as wearing shoes indoors, and where to place supplies
  • Informing patient of assessment, exams and procedures to be performed


A study reviewing the aspects of patient experience most important to patient satisfaction identified participative provider care and staff courtesy as accounting for close to 40 percent of the variance in the patients’ experiences of care.

A key aspect of achieving courtesy and respect begins with the organizational leadership and establishing a culture that supports these values across the organization.  Ensuring staff feel treated with courtesy and respect increases when everyone within the organization practices common courtesies (e.g. greeting, genuinely caring about team members) on an ongoing basis, monitoring their perceptions and incorporating their ideas.  As satisfied staff work on various aspects of patient care, they will more deeply engage and encourage patient participation in their personal care.  Once established within the organization, it will naturally become a routine part of patient care and eventually reflected in the results of the patient experience survey.

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

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