Quality Assurance Guidelines CAHPS® Hospital Survey - HCAHPS

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30 Centers for Medicare & Medicaid Services HCAHPS Quality Assurance Guidelines V6.0
Communications and Technical Support Overview Hospitals/Survey vendors have access to a number of sources of information regarding HCAHPS. These sources are listed below. Information and Technical Assistance For information and technical assistance, contact HCAHPS Information and Technical Support. ‣ Via email at hcahps@azqio.sdps.org ‣ Via telephone 1-888-884-4007 When contacting the HCAHPS Project Team regarding a specific hospital, be sure to provide the following information in your email or telephone voice mail: ‣ Hospital six-digit CMS Certification Number (CCN) ‣ Hospital name General Information, Announcements and Updates To learn more about HCAHPS and to view important new updates and announcements please visit the HCAHPS Web site at: http://www.hcahpsonline.org. Centers for Medicare & Medicaid Services 31 HCAHPS Quality Assurance Guidelines V6.0
Page 1: CAHPS ® Hospital Survey (HCAHPS) Q
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Page 14 and 15: Introduction and Overview March 201
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Telephone Only Survey Administratio
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Mixed Mode Survey Administration Ma
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Active Interactive Voice Response (
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Data Specifications and Coding Marc
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Data Preparation and Submission Mar
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Oversight Activities March 2011 HCA
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Oversight Activities March 2011 wit
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Data Reporting March 2011 Bar graph
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Exceptions Request/Discrepancy Repo
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Appendices March 2011 O. Participat
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HCAHPS Survey SURVEY INSTRUCTIONS
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15. During this hospital stay, were
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HCAHPS Survey SURVEY INSTRUCTIONS
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14. During this hospital stay, how
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Sample Initial Cover Letter for the
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Sample Follow-up Cover Letter for t
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OMB Paperwork Reduction Act Languag
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APPENDIX B HCAHPS MAIL SURVEY (Span
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4. Durante esta vez que estuvo en e
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CALIFICACIÓN GENERAL DEL HOSPITAL
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6 March 2011
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4. Durante esta vez que estuvo en e
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CALIFICACIÓN GENERAL DEL HOSPITAL
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12 March 2011
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14 March 2011
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16 March 2011
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HCAHPS 意見調查問卷指
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14. 此次住院期間 , 醫
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26. 您屬於哪一種族 ?
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問卷指示 ♦ 您是信函
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12. 此次住院期間 , 您
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26. 您屬於哪一種族 ?
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Sample Follow-Up Cover Letter for t
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OMB 減低公文法案 Overvie
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APPENDIX D HCAHPS MAIL SURVEY (Russ
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4. Во время данного
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ОБЩИЙ РЕЙТИНГ БОЛЬ
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6 March 2011
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4. Во время данного
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ОБЩИЙ РЕЙТИНГ БОЛЬ
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12 March 2011
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14 March 2011
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THĂM DÒ Ý KIẾN HCAHPS CHỈ D
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14. Trong lần nằm bệnh viện
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THĂM DÒ Ý KIẾN HCAHPS CHỈ D
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15. Trong lần nằm bệnh viện
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[SAMPLED PATIENT NAME] [ADDRESS] [C
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OMB Paperwork Reduction Act Languag
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APPENDIX F Telephone Script (Englis
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NOTE: SEE INTERVIEWING GUIDELINES I
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Q2 During this hospital stay, how o
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Q11 How often did you get help in g
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Q19 During this hospital stay, did
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[FOR TELEPHONE INTERVIEWING, QUESTI
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Overview HCAHPS Telephone Script (S
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S1 La información que tenemos indi
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Q6 Durante esta vez que estuvo en e
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Q14 Durante esta vez que estuvo en
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Q21 Queremos saber la calificación
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Q26A ¿Es usted Blanco/a? Sí/Blan
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APPENDIX H IVR Script (English)
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NOTE: SEE INTERVIEWING GUIDELINES I
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Q16 Before giving you any new medic
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Q23_INTRO This last set of question
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Q27 What language do you mainly spe
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HCAHPS Interviewing Guidelines for
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• Skip patterns should be program
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APPENDIX J Frequently Asked Questio
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‣ How can I verify this survey is
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I understand your concern. This is
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6 Centers for Medicare & Medicaid S
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HCAHPS SAMPLE FRAME FILE LAYOUT Bel
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Data Element Length Value Labels an
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Data Element Length Value Labels an
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APPENDIX L Data File Structure Vers
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Determination of Service Line Elig
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Discharge Status Patient’s disch
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Survey Language Identify whether s
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Q9 “During this hospital stay, h
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Q22 “Would you recommend this ho
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07/01/2011 and forward discharges H
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Sample XML File Layout Without DSRS
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1 1 1 1 1 1 1 1 1 1 1 1 0 0 0 0 1
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- 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
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10 1 1 - 1 1 1 1 1 1 1 1 1 1 1 1
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APPENDIX N Quality Assurance Plan O
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4. Provide and attach an HCAHPS org
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C. Describe the process for convert
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D. Describe any opportunities for i
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HCAHPS Participation Form For Hospi
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2. Organizational Survey Capacity I
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APPENDIX P Participation Form for H
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3. TYPE(S) OF MODE OF SURVEY ADMINI
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Hospital Name and Address (required
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6 Centers for Medicare & Medicaid S
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HCAHPS Participation Form For Surve
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IVR Mode of Survey Administration (
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If not submitting this form online
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APPENDIX R Exceptions Request Form
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II. Exception Request Please comple
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HCAHPS DISCREPANCY REPORT FORM Sect
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