|Info As Of
||The measure calculates the percentage of individuals discharged in a six-month time period from a SNF, within 100 days of admission, who are satisfied. This patient reported outcome measure is based on the CoreQ: Short Stay Discharge questionnaire that utilizes four items. The following are the four items: 1. In recommending this facility to your friends and family, how would you rate it overall (Poor, Average, Good, Very Good, or Excellent) 2. Overall, how would you rate the staff (Poor, Average, Good, Very Good, or Excellent) 3. How would you rate the care you receive (Poor, Average, Good, Very Good, or Excellent) 4. How would you rate how well your discharge needs were met (Poor, Average, Good, Very Good, or Excellent)
||The numerator is the sum of the individuals in the facility that have an average satisfaction score of greater than or equal to 3 for the four questions on the CoreQ: Short Stay Discharge questionnaire that utilizes four items.
The following are the four items:
1.In recommending this facility to your friends and family, how would you rate it overall (Poor, Average, Good, Very Good, or Excellent)
2.Overall, how would you rate the staff (Poor, Average, Good, Very Good, or Excellent)
3.How would you rate the care you receive (Poor, Average, Good, Very Good, or Excellent)
4. How would you rate how well your discharge needs were met (Poor, Average, Good, Very Good, or Excellent)
||The denominator includes all of the patients that are admitted to the SNF, regardless of payor source, for post-acute care, that are discharged within 100 days; who receive the survey (e.g. people meeting exclusions do not receive a questionnaire) and who respond to the CoreQ: Short Stay Discharge questionnaire within two months of receiving the questionnaire.
||Exclusions made at the time of sample selection and the following: (1) Patients who died during their SNF stay; (2) Patients discharged to a hospital, another SNF, psychiatric facility, inpatient rehabilitation facility or long term care hospital; (3) Patients with court appointed legal guardian for all decisions; (4) Patients discharged on hospice; (5) Patients who left the nursing facility against medical advice (AMA); (6) Patients who have dementia impairing their ability to answer the questionnaire defined as having a BIMS score on the MDS 3.0 as 7 or lower. [Note: we understand that some SNCCs may not have information on cognitive function available to help with sample selection. In that case, we suggest administering the survey to all residents and assume that those with cognitive impairment will not complete the survey or have someone else complete on their behalf which in either case will exclude them from the analysis.] Additionally, once the survey is administered, the following exclusions are applied: (a) Patients who responded after the two-month response period; and (b) Patients whose responses were filled out by someone else. (Note this does not include cases where the resident solely had help such as reading the questions or writing down their responses.) Surveys returned as un-deliverable are also excluded from the denominator.
||Collecting satisfaction information from skilled nursing facility (SNF) patients is more important now than ever. We have seen a philosophical change in healthcare that now includes the patient and their preferences as an integral part of the system of care. The Institute of Medicine (IOM) endorses this change by putting the patient as central to the care system (IOM, 2001). For this philosophical change to person-centered care to succeed, we have to be able to measure patient satisfaction for these three reasons: (1) Measuring satisfaction is necessary to understand patient preferences. (2) Measuring and reporting satisfaction with care helps patients and their families choose and trust a health care facility. (3) Satisfaction information can help facilities improve the quality of care they provide. The implementation of person-centered care in SNFs has already begun, but there is still room for improvement. The Centers for Medicare and Medicaid Services (CMS) demonstrated interest in consumers perspective on quality of care by supporting the development of the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey for patients in nursing facilities (Sangl et al., 2007). Further supporting person-centered care and resident satisfaction are ongoing organizational change initiatives. These include: the Advancing Excellence in America s Nursing Homes campaign (2006), which lists person-centered care as one of its goals; Action Pact, Inc., which provides workshops and consultations with nursing facilities on how to be more person-centered through their physical environment and organizational structure; and Eden Alternative, which uses education, consultation, and outreach to further person-centered care in nursing facilities. All of these initiatives have identified the measurement of resident satisfaction as an essential part in making, evaluating, and sustaining effective clinical and organizational changes that ultimately result in a person-centered philosophy of care. The importance of measuring resident satisfaction as part of quality improvement cannot be stressed enough. Quality improvement initiatives, such as total quality management (TQM) and continuous quality improvement (CQI), emphasize meeting or exceeding customer expectations. William Deming, one of the first proponents of quality improvement, noted that one of the five hallmarks of a quality organization is knowing your customer s needs and expectations and working to meet or exceed them (Deming, 1986). Measuring resident satisfaction can help organizations identify deficiencies that other quality metrics may struggle to identify, such as communication between a patient and the provider. As part of the U.S. Department of Commerce renowned Baldrige Criteria for organizational excellence, applicants are assessed on their ability to describe the links between their mission, key customers, and strategic position. Applicants are also required to show evidence of successful improvements resulting from their performance improvement system. An essential component of this process is the measurement of customer, or resident, satisfaction (Shook & Chenoweth, 2012). The CoreQ: Short Stay Discharge questionnaire can strategically help nursing facilities achieve organizational excellence and provide high quality care by being a tool that targets a unique and growing patient population. Over the past several decades, care in nursing facilities has changed substantially. Statistics show that more than half of all elders cared for in nursing homes are now discharged home (approximately 1.6 million residents; CMS, 2009). Moreover, when satisfaction information from current residents (i.e., long stay residents) is compared with those of elders discharged home, substantial differences exist (Castle, 2007). This indicates that long stay and short stay residents are different populations with different needs in the nursing facilities. Moreover, residents are more likel