2025 Southeastern Residency Conference

Title: Optimizing Patient Care: The Role of Pharmacy-Driven Nursing Education in Enhancing Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Scores

Authors: Leah Franks and David Collette

Background: The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey is a national patient satisfaction tool that measures the perception of hospital care. This survey is completed by patients after discharge. Associated scores are directly linked to hospital reimbursement and STAR ratings. A review of recent Huntsville Hospital HCAHPS results revealed that scores were lowest surrounding the Communication about Medicines Domain. This domain addresses whether the indications and side effects of medications were discussed with patients during their hospital stay. Thus, the purpose of this pharmacy pilot project is evaluating if targeted pharmacy education on low-scoring nursing units results in an HCAHPS score improvement.

Methods: A single-center, institutional review committee approved, pre-post analysis was conducted at Huntsville Hospital to assess the impact of pharmacist-driven education as it relates to HCAHPS score improvement. The primary endpoint for this study was HCAHPS Top Box score improvement regarding the “Communication about Medicines” HCAHPS domain.  This study reviewed HCAHPS data (provided by Press-Ganey (PG)) between November 2023 to February 2025. As principal investigator, I worked with the Patient Experience Team to develop education materials for both nurses and patients in an effort to improve the patient experience in regards to the communication surrounding medication administration. Education materials developed included medication tip sheets and nursing education documents. Discussion with nursing unit directors and educators regarding advantages and barriers to success was required before implementation of process change could take place. Analysis was performed by PG and sent to primary investigator for review for pre-data (November 2023 – February 2024) and post-data (November 2024 – February 2025).

Results: A medical unit, two surgical units (A & B), and a neurological unit were included in the study. Pre-implementation Top Box Percentage scores (PG Percentile Rank) were as follows for each unit: Medical Unit – 59.72 (50), Surgical Unit A – 49.28 (5), Surgical Unit B – 57.29 (35), and Neurological Unit – 67.45 (89). Post implementation Top Box scores (PG Percentile Rank) were as follows: Medical Unit – 60.29 (45), Surgical Unit A – 67.43 (85), Surgical Unit B – 54.17 (13), and Neurological Unit – 44.00 (1). Monthly trends of each unit reveal fluctuations in overall data surrounding the primary endpoint.  In addition, at a pilot study debrief with hospital administration and nurse managers for each of the four units, differences in implementation methods for each unit was reported.

Conclusion: Overall, mixed results were seen across the units regarding the primary endpoint. A numerical increase was seen in the Top Box Scores for two out of the four units. Of note, after implementation differences were noted in the debrief, it was concluded that having a higher degree of nurse leadership integration/dissemination of the medication tip sheets correlated with higher HCAHPS Top Box scores.  Limitations included the variations in nursing unit implementation of the pilot project, nurse turnover, inability of primary investigator to participate in repeat educations for nursing units, and small sample size. A clear, general implementation plan would need to be utilized before hospital-wide or system-wide implementation could take place.