Ambulatory Service Centers Earn Highest Patient Satisfaction Rates

Ambulatory service centers (ASCs) received higher reported patient satisfaction scores compared to hospital outpatient departments (HOPDs) and hospitals providing pediatric care, according to The Leapfrog Group’s latest Patient Experience Report.

The nonprofit patient safety watchdog group analyzed results from Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys to measure patient experience across hospitals and ASCs.

The CAHPS Hospital Survey (HCAHPS) is a widely used standardized hospital survey, and results are collected and publicly reported by CMS. In addition, researchers analyzed the CAHPS Child Hospital Survey (Child HCAHPS) and the CAHPS Outpatient and Ambulatory Surgery Survey (OASCAHPS).

The Child HCAHPS and OASCAHPS surveys are not publicly reported by CMS, so Leapfrog relied on data voluntarily reported by ASCs and hospitals providing pediatric care.

According to HCAHPS results, an average of 52 percent of patients in general hospitals reported that they clearly understood their care transition and post-discharge responsibilities. This leaves almost half of patients in the dark and poses a serious patient safety risk, the report's authors said. Additionally, an average of 64 percent of patients in general hospitals reported feeling confident about medication communication. Overall, patients reported better experiences at outpatient departments compared to hospitals. 

“This area reflects patients’ feedback on how often hospital staff explained the purpose of any new medicine and what side effects that medicine might have,” the report explained.

“Effective communication about medicine can help reduce or prevent medication errors, which occur on average once per patient per day among Medicare beneficiaries.”

Pediatric patient experience surveys told a different story. An average of 80 percent of parents or guardians responded favorably to communication about their child’s medicine, and the majority of parents had positive experiences in communicating with nurses and doctors.

An average of 62 percent of respondents gave favorable responses regarding their ability to prevent mistakes and report concerns to their child’s care team, which was the lowest rating of all survey domains. The report noted that parents feeling empowered to speak up about potential errors in their child’s care often reduces harm and increases patient safety.  

ASCs were rated more favorably in all categories compared to HOPDs regarding same-day surgeries. However, both ASCs and HOPDs received ratings over 95 percent when respondents were asked about facilities, staff, and communications about their procedures.

Patients were less enthusiastic about recommending these facilities to friends or family, with ASCs averaging 87.6 percent and HOPDs averaging 82.1 percent. Despite high ratings across the board, trends in ASC, HOPD, and pediatric care department ratings point to recurring communication issues between patients and their care team.

"Patient experience surveys are the voice of the American patient, and that voice should be the first authority we listen to," Leah Binder, president and CEO of The Leapfrog Group, stated publicly.

"We are worried about signs of patient safety problems, particularly in pediatric units, where parents appear hesitant to raise concerns about mistakes. We also see issues with communication that can lead to patient harm. Outpatient facilities and particularly ASCs appear to be rated more favorably by their patients, which is promising, but all facilities have work to do."

Improved patient experience can lead to better health outcomes and a lower risk of readmission, the report explained. A focus on improving patient experience could be crucial to improving health outcomes and cutting costs, and CMS has taken notice. CMS recently approved consulting firm Press Ganey to administer the Primary Care First Patient Experience of Care Surveys, which will provide valuable insight into patient satisfaction in primary care.