Quality Measurement and Quality Improvement Projects


Consumer Assessment of Health Providers and Systems Surveys and Analysis with Tribes


The CAHPS survey was developed by the Agency for Healthcare Research and Quality (AHRQ) as a standardized method for assessing patient experiences and rating of healthcare providers and healthcare systems. There are several versions of CAHPS surveys, including clinicians/medical groups, hospitals, dialysis centers, home health care, and others. CAHPS survey results offer a number of advantages to users:

  • The CAHPS survey is in the public domain and may be used by anyone.
  • Users can augment the core CAHPS survey questions with additional questions covering topics of specific interest and importance to individual users.
  • The core CAHPS survey questions are standardized and can be compared to survey results from other health care providers and systems that are available on the CAHPS Benchmarking Database.
  • The CAHPS survey is used by CMS to assess patient experiences with Medicare Advantage plans and with Medicare fee-for-service providers.
  • The National Quality Forum has endorsed the use of the CAHPS Clinician & Group Survey for assessing patient experiences.

An IHS/Tribal version of CAHPS has been developed by Sundance Research Institute, with input from Tribal Health Directors and IHS representatives, and implemented at several IHS ambulatory facilities for performance monitoring and identifying opportunities for quality improvement. At two IHS facilities, the American Indian CAHPS was conducted before beginning to participate in the IHS Improving Patient Care (IPC) initiative and again two years later. At both facilities, statistically significant improvement in patient ratings of their experience with IHS were documented two years after IPC began.

Sundance Research Institute implemented the augmented CAHPS survey, prepared the survey database, and analyzed and reported survey results. In addition, staff members worked with Tribal personnel to identify several performance improvement strategies and methods for implementing chosen goals. Funding for these projects was provided by AHRQ and the Robert Wood Johnson Foundation.

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