Patient Research
Physician Research
Community Research
Employee Research 

Patient Research

Can questionnaires be customized?

While customization is available, there are tremendous benefits to consistent utilization of a highly reliable and thoroughly tested survey instrument. If benchmarks are important, we recommend starting your patient research with an HCAHPS-based “Core” survey with a Core+Custom design allowing for unique questions (both scaled and open-ended) to be added to the core survey.   One of the advantages of adopting HCAHPS as your inpatient core survey is the ability to have the national database norms organized by CMS and AHRQ. 

However, if you require a completely custom survey we can help you with that as well. This is just one of the advantages to working with a research firm that places your information needs as a top priority.  Not only can your questionnaires be completely customized, you can change questions for your patient satisfaction “tracking” study AT NO ADDITIONAL COST and from one quarter to the next, if you like.  

With HCAHPS, have most of your clients chosen to administer two surveys—HCAHPS and their traditional patient satisfaction survey?

The majority of HealthStream Research's clients are either in the process of moving to HCAHPS-based surveys or have already moved to this approach. Many are also beginning to use HealthStream Research's HCAHPS-based surveys for Outpatient, ED and other surveys for units not yet covered by the CMS or soon to be included in the CMS initiative. 

There are many reasons our clients are making this transition. Primarily, it makes quality improvement efforts more effective and easier to manage if you are using a similar instrument across the organization and not trying to manage separate surveys. Plus, this approach provides the best opportunity for benchmarking across the entire organization since the same survey is being used across all patient types. 

Are survey results available for review on-line?

Yes.  Through our online reporting system, you can view results, filter information, download data and more. We assign “security-level-appropriate” User IDs and Passwords to a number of persons within your organization so that the CEO and the senior quality management executives will be able to review organization-wide results, while a given nurse manager will be able to view the numbers corresponding only to his or her patient care unit.

Which is better for patient surveys, mail or phone?  
Actually, both are acceptable. However, HealthStream Research utilizes telephone (CATI—Computer Aided Telephone Interview) for nearly all patient survey research.  While HealthStream Research is able to conduct surveys across all methodologies, we recommend telephone as the mode of HCAHPS administration and patient research.

HealthStream Research’s telephone methodology (successfully utilized by all of our clients, including large healthcare systems) provides high response rates, statistically valid results, and significant cost savings—our patient satisfaction/HCAHPS administration will produce completed surveys within days after patient discharge (with data posted real-time).

What opportunities are there for comparing (benchmarking) our patient survey results to those of other healthcare organizations?

We recommend beginning with our Core survey which asks about the experience elements that have the strongest correlations to high satisfaction and high loyalty. Our robust database provides benchmarking against they key indicators.  We then take it further and provide you the opportunity to designate peer groups in which to benchmark.

As mentioned above, one of the biggest advantages of adopting HCAHPS as your core inpatient tool is the opportunity to have national comparative database norms organized by CMS and AHRQ.  In Fall 2008, the full-blown public reporting of HCAHPS results will begin.  With this, a national database of 4,000 hospitals will be available.  HealthStream Research will use this large database as the main inpatient database for our clients. This database will be the largest patient satisfaction database in the nation.

HealthStream Research also has CMS-approved methods for obtaining unit-specific benchmarking, which clients have asked for in order to satisfy both CMS’s need for HCAHPS reporting as well as the hospital’s need to accurately measure on a unit-by-unit basis—for manager accountability, targeted improvement, and specific problem identification.

Physician Research

What percentage of the medical staff should participate in a Physician Satisfaction Survey?

HealthStream Research recommends a census survey approach for physicians, as the goal is to provide all physicians with an opportunity to participate.  With that in mind, we set sample size targets that allow for your data segmentation requirements (for example, admitting volume/loyalty status), rather than being dictated by the size of the “universe.”  We begin the survey process with a census mailing to all eligible physicians, and we then follow up with another mailing or phone calls to help you achieve the highest possible response rate.

How often do most of your facilities survey their physicians?

Most facilities conduct medical staff research once per year.  This frequency provides the necessary time to make improvements within the organization that will positively impact scores, but doesn't go so long that you cannot address areas that are not being impacted.

Can HealthStream Research survey referring physicians too?

Yes, we’ll survey referring physicians using the same high-response method as with your own medical staff.

Community Research  

How will you evaluate my organization's branding effectiveness in the consumer market?

Due to certain statistically-supported observations our analytical team has made concerning consumerism trends since the late 1980s.  HealthStream Research is convinced that the branding effectiveness of a healthcare organization (and, ultimately, its viability in a competitive healthcare environment) is driven by the factors of Awareness, Image, Preference Share, Market Share and Patient Loyalty.  We also know that these factors have unequal weights in driving brand equity in the marketplace. Thus, our analysis of the importance of these factors has produced a survey that can determine the effectiveness of your organization’s branding effectiveness.

Is there a way to monitor my organization's (and competitors') branding effectiveness on a quarter-to-quarter basis, rather than just every 12 to 18 months?

Yes! HealthStream Research offers a creative, quantitative research tool that will measure, on an ongoing basis, your organization's branding effectiveness. The consumer ImageTrack/Brand Equity Profile will measure consumer awareness, image, preference share, market share and customer loyalty for your organization and your chief competitors. Typically characterized by a quarterly reporting cycle and monthly top-line summaries, your ImageTrack/Brand Equity Profile will feature a quarterly update of your Brand Equity Index and that of key competitors. Since this consumer survey is in the field constantly, it is standing by and is ready to accept additional questions or temporary sample-size boosts that you may need in order to measure the impact of any particular image-affecting event.

What is the optimal sample size for a community survey?

Recommendations for sample size are primarily based on error ranges found to be acceptable by both HealthStream Research’s analysts and the client.  A sample of 100 gives an error range of ±9.8%, while just adding an extra 200 to the sample size causes the error range to drop more than 4 percentage points to ±5.7.  But to improve the error range by an additional 4 percentage points, from ±5.7 to ±1.7, you would have to increase the sample size to a budget-restrictive and time consuming 3,200.  “Optimal sample size” depends on your budget, segmentation requirements, and the “drill-down” depth you need to achieve.

How should I define my primary service area, for sampling purposes?

Most hospitals already have their primary service area defined, but a good rule is to regard your primary service area as that set of (usually contiguous) zip codes where the hospital gets 60%-70% of its patients.

Employee Research

What is the reason you should do an employee survey in the first place?

At HealthStream Research we believe there is only one reason to survey the employees, to uncover the information that enables you to implement action plans that will make the needed improvements in the organizational environment.

If you are genuinely interested in changing the environment for the better, an Employee Satisfaction Survey by HealthStream Research may be the vehicle to get you there.  We provide more than just an employee survey and a report in a 3-ring binder.  We show you where and how to make noticeable improvements, provide onsite training and point you in the direction of an improved work environment.

Does it matter how employees are surveyed?

Yes, although the key determinants in choosing a survey methodology are ensuring employee confidentiality and achieving reasonable response rates.  At HealthStream Research we’ll develop a data collection methodology plan that will enable you to get the highest response rates so you can have confidence in the decisions you make that will impact the employees and your organizational culture.

What questions are the most important questions to ask in an employee survey; and how do you learn which ones are right for your hospital?

The ones that allow you to make the discoveries needed to improve your organizational climate are the most important.  We recommend our Core set of questions which have been thoroughly tested for their reliability and validity and have proven to be highly predictive of hospital employees’ overall satisfaction with their place of work.  These questions also allow you to benchmark against national norms.  Often there are times when custom questions need to be asked to support decision-making within your organization.  Each time you administer the HealthStream Research Employee Satisfaction Survey you have the option to include custom questions important to your facility.  To maintain the reliability and validity of the core survey instrument, custom questions are included at the end of the survey and can be changed each survey cycle.