Improving Home Health CAHPS Results: Communications Between Providers and Patients


The Home Health Consumer Assessment of Healthcare Providers and Systems (HHCAHPS) patient engagement survey impacts the bottom line of home health agencies primarily by 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.

Communications Between Providers and Patients – Question 2

Question two is one of six questions designed to determine patients’ feelings about how well their healthcare providers communicated with them, and is included in the Communications Between Providers and Patients domain of the Home Health CAHPS survey.  The following can be reviewed in multiple staff meetings to ensure that all team members are equipped to effectively communicate with patients about their healthcare and treatment plans.

Communications Between Providers and Patients

“Patients who reported that their home health team always communicated well.” Responses
Q2. When you first started getting home health care from this agency, did someone from the agency tell you what care and services you would get? Yes, No
Q15. In the last 2 months of care, how often did home health providers from this agency keep you informed about when they would arrive at your home? Never, Sometimes, Usually, Always
Q17. In the last 2 months of care, how often did home health providers from this agency explain things in a way that was easy to understand? Never, Sometimes, Usually, Always
Q18. In the last 2 months of care, how often did home health providers from this agency listen carefully to you? Never, Sometimes, Usually, Always
Q22. In the last 2 months of care, when you contacted this agency’s office did you get the help or advice you needed? Yes, No
Q23. When you contacted this agency’s office, how long did it take for you to get the help or advice you needed? Same day, 1 to 5 days, 6 to 14 days, More than 14 days

This question seeks to assess the perception of the patient, and whether the agency clearly communicated the care services and goals before providing them. The ability of the provider to show preparedness and efficacy when orienting the patient to agency services will help set the tone for care, and improve results on the survey and overall care.

Suggestions for Communications Improvement

  • Thoroughly orient the patient to agency services during admission, including the goals of the home healthcare services and how they relate to the patient’s diagnosis.
  • Provide written instructions on accessing key home health contacts such as care manager, overview of services to be provided, and any patient specific information requiring reinforcement.
  • Throughout care, periodically reinforce the goals of the home healthcare services, and actively associate all care provided to the patient’s diagnosis.
  • Use changes in patient condition as an opportunity to establish new goals and objectives, and to reinforce education about the patient’s condition, and how the services provided will address and improve patient desired goals.
  • In cases of dementia or altered mental states, communicate openly and clearly with authorized patient family members, proxy or guardians, and patient representatives. These may be the individuals completing the HHCAHPS survey.

Note Potential Barriers to Communication

Maintaining open communication with patients is a fundamental and critical need for providing patient-centered care. It is important for staff to note potential barriers to communication and address them to ensure patients understand the information shared. These might include literacy, linguistic and physical barriers (e.g., hearing aids, illness exceeding coping capacity). It is also possible to reference previously shared information after a patient’s health becomes stable (e.g., “When initiating care, remember we told you we would be visiting twice a week to …”). Agencies should prepare healthcare providers to communicate successfully with patients by ensuring clinicians’ access to the most current patient information, and delivering ongoing training and role playing to optimize patient communication.

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.

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