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1 Strategic Leadership and Future Delivery Models College of Health Professions, Western Governors University C163 Strategic Leadership and Future Delivery Models This paper will analyze the Hospital Consumer Assessment of Health Care Providers and Systems (HCAHPS) for St. Lukes Hospital. A plan will be developed, and interventions put in place for the three domains with the lowest scores. The scores are open to the public and can be

2 retrieved to compare responses from other patients on their experience in that facility. For the purpose of this paper this organization will be compared to two other hospitals as well as the state and national averages in eleven core measures ( U.S. Centers for Medicare & Medicaid Services, n.d. - a). Section A A1. HCAHPS Scores St. Lukes Hospital is located in Bethlehem, Pennsylvania is a 480 bed facility that serves as the main hub to 13 other campuses. This nonprofit organization works to serve 70,000 patients annually in the Emergency Department with positive results from HCAHPS surveys yielding organizational reimbursement (St. Lukes University Hospital - Bethlehem Campus, 2020). The HCAHPS is a national, standardized, public survey developed by The Centers for Medicare and Medicaid Services ( U.S. Centers for Medicare and Medicaid Services, 2019). The survey consists of a series of questions based on patients hospital experience, the results can positively or negatively impact reimbursement. Below is the HCAHPS scores for St. Lukes Bethlehem: Survey Questions St. Lukes Hospital Patients who reported that their nurses "Always" communicated well. 82% Patients who reported that their nurses "Always" communicated well. 82% Patients who reported that they "Always" received help as soon as they wanted. 68% Patients who reported that the staff "Always" explained about medicines before giving it to them. 62% Patients who reported that their room and bathroom were "Always" clean. 76% Patients who reported that the area around their room was "Always" quiet at night. 52%

3 Survey Questions St. Lukes Hospital Patients who reported that YES, they were given information about what to do during their recovery at home. 88% Patients who "Strongly Agree" they understood their care when they left the hospital 56% Patients who gave their hospital a rating of 9 or 10 on a scale from 0 (lowest) to 10 (highest). 79% Patients who reported YES, they would definitely recommend the hospital. 79% (U.S. Centers for Medicare & Medicaid Services, n.d. - b) Section B B1. State and National Averages ST. LUKE’S HOSPITAL PA AVERAGE NATIONAL AVERAGE Patients who reported that their nurses "Always" communicated well. 82% 82% 81% Patients who reported that their nurses "Always" communicated well. 82% 81% 82% Patients who reported that they "Always" received help as soon as they wanted. 68% 70% 70% Patients who reported that the staff "Always" explained about medicines before giving it to them. 62% 64% 66% Patients who reported that their room and bathroom were "Always" clean. 76% 75% 76% Patients who reported that the area around their room was "Always" quiet at night. 52% 56% 62% Patients who reported that YES, they were given information about what to do during their recovery at home. 88% 88% 87%

4 ST. LUKE’S HOSPITAL PA AVERAGE NATIONAL AVERAGE Patients who "Strongly Agree" they understood their care when they left the hospital 56% 53% 54% Patients who gave their hospital a rating of 9 or 10 on a scale from 0 (lowest) to 10 (highest). 79% 73% 73% Patients who reported YES, they would definitely recommend the hospital. 79% 70% 72% (U.S. Centers for Medicare & Medicaid Services, n.d.-b) From the data gathered it is clear that St. Luke’s has preformed better than the PA average in all categories except three. “Patients who reported that they "Always" received help as soon as they wanted.”, “Patients who reported that the staff "Always" explained about medicines before giving it to them.”, and “Patients who reported that the area around their room was "Always" quiet at night.” St. Lukes had lower percentages in those measures in comparison to the PA average. When comparing St. Luke’s and National data 5 categories were above the average while 2 were the same. The three categories that were short of the national average were the same categories when comparing St. Luke’s to the PA average. B2. Comparison of Hospitals ST. LUKE’S HOSPITAL GRAND VIEW HOSPITAL DOYLESTOWN HOSPITAL PA AVERAGE NATIONAL AVERAGE Patients who reported that their nurses "Always" communicated well. 82% 83% 85% 82% 81% Patients who reported that their nurses 82% 77% 80% 81% 82%

5 ST. LUKE’S HOSPITAL GRAND VIEW HOSPITAL DOYLESTOWN HOSPITAL PA AVERAGE NATIONAL AVERAGE "Always" communicated well. Patients who reported that they "Always" received help as soon as they wanted. 68% 70% 74% 70% 70% Patients who reported that the staff "Always" explained about medicines before giving it to them. 62% 65% 63% 64% 66% Patients who reported that their room and bathroom were "Always" clean. 76% 76% 71% 75% 76% Patients who reported that the area around their room was "Always" quiet at night. 52% 56% 49% 56% 62% Patients who reported that YES, they were given information about what to do during their recovery at home. 88% 92% 89% 88% 87% Patients who "Strongly Agree" they understood their care when they left the hospital 56% 54% 56% 53% 54% Patients who gave their hospital a rating of 9 or 10 on a scale from 0 (lowest) to 10 (highest). 79% 80% 81% 73% 73%

6 ST. LUKE’S HOSPITAL GRAND VIEW HOSPITAL DOYLESTOWN HOSPITAL PA AVERAGE NATIONAL AVERAGE Patients who reported YES, they would definitely recommend the hospital. 79% 76% 84% 70% 72% (U.S. Centers for Medicare & Medicaid Services, n.d.- b) (U.S. Centers for Medicare & Medicaid Services, n.d.- c) (U.S. Centers for Medicare & Medicaid Services, n.d.-d) When comparing the data between the three families, St. Luke’s Hospital ranks the highest in only one of the ten categories “Patients who reported that their nurses "Always" communicated well.” St. Luke’s has performed the same as the other facilities in two categories and ranked the lowest in five categories. Grandview Hospital ranks highest in three categories in comparison to St. Luke’s and Doylestown Hospital. Grandview performed the same as St. Luke’s in one category and ranked the lowest in three categories. Doylestown ranks the highest in four of the categories and the lowest in two categories while perming the same as St. Luke’s in one category. B3. Survey Response Rates ST. LUKE’S HOSPITAL GRAND VIEW HOSPITAL DOYLESTOWN HOSPITAL Number of surveys completed 499 498 879 Survey response rate 23% 32% 37% After reviewing the data gathered from the three hospitals, Doylestown has the highest response rate with 879 surveys completed a 37% response rate. Grandview follows second with

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