The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a national, standardized, publicly reported survey of patient satisfaction that is directly tied to hospitals’ reimbursements.

And while patient perception may largely be influenced by the care delivered as well as who is delivering it, D. Paul Shackelford Jr., MD, senior vice president medical affairs, Vidant Medical Center in Greenville, N.C., says there are plenty of other factors that contribute to the patient experience that start at the facilities level.

Shackelford presented the session “How to Improve HCAHPS Scores” Tuesday, July 17, at the ASHE Annual Conference in San Antonio.

With 861 beds, and growing to 909, Vidant Medical Center falls into the top 1% of facilities by size. But despite its size and the large patient population it serves, the hospital manages to keep a high HCAHPS score.

“If we can get this right, the small hospitals can get this right,” he says.

And moving past those clinical issues patients are surveyed on—like communication with doctors and nurses, pain control, and discharge information—there are other more practical items on the survey, including cleanliness of the hospital environment, quiet, overall hospital rating, and likelihood to recommend the facility.

From the facilities standpoint, Shackelford says ensuring perception of the facility stays positive starts right from the front door—just like curb appeal does in real estate.

“If you can’t get the shrubbery right, can you get the care right?” he says.

Of the 27 questions meeting patients on the HCAHPS survey, Shackelford advises that engineers and facility operators need to recognize the effect they can have on the results, putting a focus on the basics and attention to detail.

“Never underestimate what a piece of trash on the floor will do to perception of your facility,” he says.

There’s also a balance that must be found of what can actually be achieved, though. For example, a critical care unit is going to be noisy, and machines that are required for care are going to beep. But when it comes to noise control, there is something facilities staff can do about a squeaky cart in the corridor.

“Part of this is managing the concept of what’s expected with what’s ultimately delivered,” Shackelford says.

And with an industry push toward patient- and family-centered care, he also reminded the audience that beyond maintenance issues or systems controls, facility managers should also be interacting with patients and their visitors, doing their part to increase the communication portion of the HCAHPS scores.

Shackelford suggests having facilities staffers take part in rounding to visit with patients and enhance their overall stay. “Remember, that could be your family member,” he says.