How to Improve HCAHPS Scores: 6 Hospital Best Practices

The patient experience one has in a hospital is no longer a “nice-to-have” idea; hospitals must show that they deserve a good reputation, hefty reimbursements, and, most importantly, have patient trust.

What is the core performance metric that is tied directly to this?

It’s called HCAHPS scores, or Hospital Consumer Assessment of Healthcare Providers and Systems–what a mouthful, we know. However, every hospital needs to learn how this survey is directly related to patient satisfaction levels and, in turn, financial performance and long-term success.

Hospital administrators or operational workflow leaders-listen up—here’s how to improve your HCAHPS scores to deliver better patient-centered outcomes.

What are HCAHPS scores?

HCAHPS is a standardized survey given to a random sample of adult patients after being discharged from a hospital stay, measuring specific components of the hospital experience. Survey responses are converted into scores that CMS uses to calculate star ratings (1–5) and to determine a portion of each hospital's reimbursement through its Value-Based Purchasing program.

The survey consists of 29 questions covering specific dimensions of the hospital experience—such as nurse and doctor communication, staff responsiveness, pain management, medication explanation, discharge planning, and the care environment.

Sounds pretty straightforward, right? Well, kind of, if you are an administrator of a facility, you know how to implement a few strategies that will bring a hospital to hover around a 5-star rating.

Essentially, these surveys cover a few key areas that hospital administrators should be aware of:

Communication
Responsiveness
Cleanliness
Discharge processes and information (that enable and influence reimbursement rates)
Coordination of care
Environmental quality (such as how quiet the hospital is)
Rating of the hospital (likelihood for a patient or person to recommend the hospital)

Checking off the boxes of this list doesn’t guarantee your hospital or medical setting will receive an excellent HCAHPS score.

The challenge? While most medical facilities understand the value of each of these core elements, administrators struggle with how to implement them on a day-to-day basis.

Which leads us to our next point.

Why HCAHPS scores matter more than you think

If you are a hospital administrator, you may know that focusing on HCAHPS scores helps more than patient satisfaction—these scores also affect financial performance and competitive positioning for your facility. A good rating is especially important because it directly ties to the Centers for Medicare & Medicaid Services (CMS) reimbursement through value-based purchasing.

CMS reimbursement is the payment hospitals receive from CMS for the care they provide to Medicare and Medicaid patients. This means that improving your HCAHPS score can result in tangible financial benefits beyond what a good reputation among patients can offer.

HCAHPS scores in a nutshell:

A monitoring metric to see how patients perceive their care regardless of clinical outcomes.
A measurement that is publicly reported on official websites such as Care Compare on Medicare.gov and in the Provider Data Catalog on Data.CMS.gov
Focuses on communication, responsiveness, environment, and discharge readiness

As part of ongoing transparency efforts, CMS HCAHPS scores are updated frequently to ensure that performance is visible and relevant. When these scores are publicly reported (and they will be), they allow for hospital-to-hospital comparisons.

Take this scenario: Imagine if a patient walks through your hospital doors with a severe chest cold. Triage does not take this patient’s symptoms seriously enough, and they wait in the emergency room for over 2 hours.

Finally, a nurse notices this patient is having an extremely hard time breathing, eventually passing out. The patient is rushed to an emergency bed and immediately transferred to the critical care unit (CCU).

Their diagnosis? Pneumonia that has moved into their lungs requires immediate oxygen support, aggressive antibiotics, and close monitoring. This care might have been far less intensive if treatment had started earlier.

The outcome? The patient survives and is discharged from the hospital in 24 hours.

The patient’s perception of their experience? Likely, very low. In fact, these types of scenarios are exactly what drive down HCAHPS scores.

Sure, the patient survived, but their fear, exhaustion, and the delay of nursing care will overshadow the positive outcome—make sense?

So how can administrators improve their scores today? For starters, think about your hospital from a patient’s perspective.

6 Steps to improve your HCAHPS score

Improving your HCAHPS scores won’t happen overnight. It takes time and dedication to each of the following core areas to begin to see improvement over time.

For now, here is where to focus first for measurable impact.

1. Improve nurse-patient communication

Improving nurse-patient communication is one of the most effective ways to enhance a patient’s perception of the hospital. To do this, use a method called “ patient rounding.” Patient rounding is a proactive nursing practice where staff regularly check on patients to address needs, improve safety, and boost satisfaction.

It centers on the “4 Ps”—pain, position, potty, and personal items to prevent issues, reduce call lights, and enhance care quality. Other ways to improve nurse-patient communication are to:

Avoid medical jargon.
Introduce staff clearly at each interaction.
Set expectations at the beginning of every shift.

While these may seem like small steps, they are all in the right direction for strengthening and reinforcing nurse-patient communication and setting your facility up for success.

2. Reduce patient wait times

No patient enjoys waiting, especially if they are in pain. Both patients and family members will become impatient if wait times become too long, whether it's waiting for the nurse to come check on them or to be discharged by the doctor.

Here are some ways to reduce patient wait times:

Streamline call light workflows: Make sure call lights are always answered quickly; this will reduce delays in care and communication.
Use support staff effectively: Delegate non-clinical or routine tasks—like helping with toileting, repositioning, or retrieving items to certified nursing assistant techs.
Identify bottlenecks during peak hours: Look for patterns when things slow down—shift changes, med pass times, or high admission periods.

3. Strengthen discharge education

Think of discharge like the last impression you give a new friend before they walk out the door of your house after a gathering. You want to make sure it’s friendly and personable, and that your friend had a good time.

Discharging a patient is similar to this. Here are some ways to improve the discharge experience for patients:

Start discharge planning early, not at the end (don’t wait until the last minute).
Use checklists for consistency; try digital checklists for efficient note-taking and checklist creation.
Reinforce instructions multiple times if you are the nurse leader to your team.

4. Reduce nighttime noise, including adjusting alarm sounds

The HCAHPS scores are based on environmental factors such as how quiet, clean, and uncluttered a facility is.

Here are a few ways hospitals and care teams can improve this experience:

Cluster care activities to minimize disruptions, i.e., keeping public areas clean and organized. Pay close attention to clutter that adds up in a patient’s room, such as meal trays, patient clothes or personal items, or any medical equipment that is not being used.
Implement “quiet hours” protocols, i.e., turn patient rooms' lights off by 10 p.m. and ask that they lower the volume of their television screens.
Adjust alarms and overhead paging practices. This not only reduces call light usage but also improves responsiveness scores, which can prevent issues before they escalate.

5. Invest in healthcare technology

Healthcare staff should also be up to date on modern medical research and treatments, including healthcare technology that can enhance a patient’s experience.

For example, a facility can improve HCAHPS scores by investing in technology such as:

Smart call light systems: These systems are made to prioritize patients with higher acuity needs and who need attention fast.
Electronic health records (EHRs): These digital records streamline communication between care teams, making writing down patient records and notes on ordinary paper a thing of the ancient past. Plus, electronic health records are a more environmentally friendly system that will be looked at fondly by healthcare professionals and patients alike.
Real-time location systems (RTLs): These nifty systems offer a way to locate staff and equipment easier than ever by using Wi-Fi, Bluetooth, and other tracking technologies to see where patients and your nursing staff are on the floor at all times.

When thoughtfully implemented, these tools don’t replace human care; they support it. This makes a hospital a more efficient, timely, and patient-centered facility.

6. Improve nurse staffing levels

Improving staffing ratio levels in nursing facilities will inevitably help with HCAHPS scores because there are simply more hands available to respond quickly.

Align staffing with patient acuity—not just census. For example, don’t base staffing only on how many patients are currently hospitalized in a unit; also, take into account how sick they are. A smaller group of high-acuity patients may require more staff than a larger group of stable ones.
Use flexible staffing models to handle census spikes. Administrators can utilize per diem staffing platforms such as Nursa to find last-minute coverage. These types of healthcare platforms will help lessen the burden of making sure enough nurses are managing a unit.
Fight nurse burnout and fatigue. Allow nurses to have more control over their schedules. For example, prioritize senior nursing staff and staff with families by offering flexible shifts, reduced workload, predictable scheduling, or preferred hours when possible.

How facility leaders can build a culture of patient experience

Nurses are the backbone of a hospital or medical facility. Without their expertise and resilience, a hospital would literally collapse.

Right now, there is a severe nursing shortage, and finding ways to increase HCAHPS scores is becoming even more challenging.

According to the Health Resources and Services Administration (HRSA), projections for 2026 show facilities facing a nationwide shortage of 94,320 licensed practical/vocational nurses and 263,870 registered nurses. Facility leaders need to be even more strategic in how they deliver care.

This means making sure all areas of patient care are essentially “checked off,” such as paying attention to patient preferences, involving them in decision-making, and delivering individualized and compassionate treatment.

In addition, hospitals should always take care of fundamental requirements such as providing a patient with food and water and ensuring that hospital facilities are clean.

Finally, hospitals can continue to improve HCAHPS scores by adapting to new information, apps, and technology that can all contribute to a more positive and empowering patient experience.

The bottom line? This year is all about paying more attention to patient care. By following the above strategies, which may seem small at first, these “small details” add up fast. They will make a huge difference in the course of a few months for both patients and your facilities' HCAHPS scores.

Need coverage? Sign up for free with Nursa to quickly post shifts and find qualified nursing talent.

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