Hospice Experience of Care Survey

Hospice Experience of Care Survey: Development and Field Test

Rebecca Anhang Price
Denise D. Quigley
Melissa A. Bradley
Joan M. Teno
Layla Parast
Marc N. Elliott
Ann C. Haas
Brian D. Stucky
Brianne Elizabeth Mingura
Karl Lorenz
Copyright Date: 2014
Published by: RAND Corporation
Pages: 75
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  • Book Info
    Hospice Experience of Care Survey
    Book Description:

    The Centers for Medicare & Medicaid Services (CMS) plans to implement a new Hospice Experience of Care Survey. This report describes the survey development process, the field test design and procedures, analytic methods and findings from the field test, and the final survey instrument for national implementation.

    eISBN: 978-0-8330-8977-9
    Subjects: Health Sciences, Sociology

Table of Contents

  1. Front Matter
    (pp. i-ii)
  2. Preface
    (pp. iii-iv)
  3. Table of Contents
    (pp. v-vi)
  4. Tables
    (pp. vii-viii)
  5. Abstract
    (pp. ix-x)
  6. Acknowledgments
    (pp. xi-xii)
  7. Abbreviations
    (pp. xiii-xiv)
  8. Chapter One. Introduction
    (pp. 1-2)

    The Centers for Medicare & Medicaid Services (CMS) has implemented experience-of-care surveys for a variety of settings, including traditional Medicare, Medicare Advantage and Part D Prescription Drug Plans, hospitals, and home health agencies. Although CMS and the Agency for Healthcare Research and Quality (AHRQ) have developed additional Consumer Assessment of Healthcare Providers and Systems (CAHPS®) surveys for in-center hemodialysis facilities, nursing homes, and clinician and group practices, none of these surveys addresses experiences with hospice care.

    In September 2012, CMS entered into a contract with RAND to design and field-test a future CAHPS survey to measure the experiences that patients...

  9. Chapter Two. Survey Instrument Development
    (pp. 3-6)

    Content and design of the HECS were informed by the following inputs:

    a call for topic areas in the Federal Register

    a review of the literature and environmental scan of existing tools for measuring experiences with end-of-life care

    qualitative inquiry (interviews and focus group) with primary caregivers of hospice patients

    input and feedback from survey and hospice care quality experts at a technical expert panel (TEP)

    cognitive testing with primary caregivers of hospice patients.

    In response to a call for topic areas published in the Federal Register in January 2013, stakeholder groups provided suggestions for survey content, including the following:...

  10. Chapter Three. Field Test Design and Procedures
    (pp. 7-22)

    From November 12 through December 23, 2013, we conducted a field test of the three setting-specific versions of the HECS. The survey was administered between two and five months after the death of the hospice patient.

    The field test was designed to assess survey administration procedures and to develop composite measures of hospice performance while enabling comparisons of response rates and response patterns for larger and smaller hospices and for the four settings of hospice care:

    home, which includes both home and assisted living facilities

    nursing home, which includes both skilled and regular nursing facilities

    two subsettings of inpatient care...

  11. Chapter Four. Final Survey Instrument
    (pp. 23-24)

    We identified items to maintain for the final survey instrument using several general guidelines. First, we removed items that were included on the field test instrument solely to facilitate tests of construct validity (e.g., “Did your family member begin getting hospice care too early, at the right time, or too late?”) and those that exhibited little variation or ceiling effects. Some items with limited variation were maintained because of the importance of the measured constructs to hospice stakeholders or consumers (e.g., an item regarding spiritual or religious support). For parallel items regarding caregivers’ and decedents’ experiences (e.g., “How often did...

  12. Appendix A: Item Response Rates Among Unit Respondents
    (pp. 25-30)
  13. Appendix B: Summary of Changes to Field Test Survey
    (pp. 31-40)
  14. Appendix C: Final English-Language Instrument for 2015 National Implementation of the Consumer Assessment of Healthcare Providers and Systems Hospice Survey
    (pp. 41-61)