Survey Tool Assesses Patient Satisfaction After Hospital Stay


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Photo: © iStockphoto/Catherine Yeulet

Jean Teller |

Comments Demonstrate Linen's Import in Providing Quality Care

RICHMOND, Ky. — Two questions on the current version of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey pertain to laundry services, and the industry can expect changes in future revisions, says Linda Fairbanks, executive director of academic affairs for the Association for Linen Management.

In a recent webinar, Fairbanks detailed the survey tool and how it has impacted how a hospital improves patient care and how patients assess a hospital stay.

“HCAHPS brings a sweeping change in the healthcare marketplace,” she says. “The impact on linen and textile services to date is small, but it’s a larger role than we first played in the first draft of HCAHPS.”

Since interviews indicate linens bear a significant role when it comes to patient satisfaction, the industry can expect future questions to relate more to the role that textiles play, Fairbanks says.


The ever-evolving tool is a quality assessment survey focusing on patient satisfaction after a hospital stay. Developed in 2002, the survey was a joint project of the Centers for Medicare and Medicaid Services, the Agency for Healthcare Research and Quality and the Department of Health and Human Resources.

The project was funded in 2005 and implemented in 2006. Data collection began in 2007, and the use of HCAHPS was tied at that time to participation in the Medicare IPPS annual payment program. If facilities wanted to continue to receive payments rapidly under the IPPS program, they were required to collect and submit HCAHPS data.

The current version of HCAHPS will generate reimbursement changes, Fairbanks says, and 2013 will bring another step, as the program will level penalties on hospitals with negative clinical outcomes.

The survey itself is composed of 27 questions, with the core measures looking at communications with nurses and doctors, staff responsiveness, pain management, information about medications, and discharge information. There are demographic questions, as well as two relating to cleanliness and quietness of a hospital, and several questions on the overall hospital rating by the patient.

The survey is given to patients who were at least 18 years old at the time of admission, who did not have a psychiatric diagnosis at discharge, and whose stay included at least one overnight.

Patients with overseas addresses or who are designated non-publicity patients—those who checked in anonymously—are excluded, as are patients who are discharged to a hospice or a skilled nursing facility.

A specific cover letter is included with the survey letter, and while hospitals can ask their own questions, it must be under the cover of a completely separate survey.

The survey can be conducted completely by mail or by telephone, or by a combination of the two. It can also be administered through an active/interactive voice response system. However, the survey must be conducted 48 hours after a patient has been discharged and within six weeks after discharge.


HCAHPS contains two questions that focus on the hospital environment, and many times comments on the survey indicate that linens played a major role in a patient’s satisfaction with a hospital stay.

The two questions ask patients to rate how often a room and bathroom were kept clean, and how quiet the area around a patient’s room was at night.

Consulting groups that are developing efforts to support HCAHPS are attempting to sharpen communications with patients in regard to responsiveness of care and why the environment of care is such an important aspect to the care experience, Fairbanks says.

Budgeting of linens often comes into play with the environment of care, she says. Distribution problems allow a linen provider to assist with a solution, and the industry can look at the use of HCAHPS as a means of determining how and when a linen provider can help a healthcare facility increase patient satisfaction.

Fairbanks mentioned keeping the provision of linens and apparel on a schedule as well as avoiding duplication of linens in a patient room. Linen departments or providers can assist a facility in avoiding duplication when a patient is admitted through the emergency department or after surgery. In these cases, a patient’s arrival in a room is accompanied by part of the linens needed; a gown, pillow, pillowcase, top sheet and blanket are usually with a patient on a stretcher. Those items do not need to already be in place in a room.

Another aspect of linen duplication is that research has shown body-core temperature, if maintained, can hold off opportunistic infections. Allowing a patient to keep the linens that accompany him from a recovery room or the emergency room will help maintain a higher body-core temperature.


HCAHPS scores allow a hospital to compare a current performance level to a past level, as well as compare one hospital to another facility. The data is already making a difference, Fairbanks says, and the laundry industry can take its own measures to show improvements.

“If the linen, if the textiles represent an area free from infection and disease, then the patient’s feeling of security that the care they’re going to receive will carry forward,” Fairbanks says. “They definitely see the value in textiles.”

About the author

Jean Teller

Contributing Editor, American Trade Magazines

Jean Teller is contributing editor at American Trade Magazines. She can be contacted at


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