CMS-10102 OMB2007 - Interactive Voice Response Script

CAHPS^ Hospital Survey

Active Interactive Voice Response Script

(English)

CAHPS^ Hospital Survey Active Interactive Voice Response Script

Overview

This IVR interview script is provided to assist interviewers while attempting to reach the respondent. The script explains the purpose of the survey and confirms necessary information about the respondent before the respondent is connected to the IVR system. Interviewers do not conduct the survey with a proxy respondent.

General Interviewing Conventions and Instructions

• All text that appears in lowercase letters should be read.

• Text in UPPERCASE letters should not be read out loud.

• All questions and all answer categories should be read as they are worded.

• Text that is underlined should be emphasized.

• Characters in < > should not be read.

• [Square brackets] are used to show programming instructions that would not actually appear on IVR screens.

• Each question should be programmed so that the respondent can go to the next question in cases where they do not know the answer or refuse to answer.

• Each question should have the option for the respondent to be connected to a live interviewer at any time during the survey.

• MISSING/DON’T KNOW (DK) is a valid response option for each item in the IVR Script. This allows the IVR system to go to the next question if a respondent is unable to provide a response for a given question (or refuses to provide a response). In the survey file layouts, a value of MISSING/DK is coded as “M.”

• Skip patterns should be programmed into the IVR system. In these instances appropriately skipped questions should be coded as 8 (Not Applicable). For example, if a respondent answers “No” to question 10 of the HCAHPS questionnaire, the program should skip question 11, and go to question 12. Question 11 should then be coded as 8 (Not Applicable). Coding may be done automatically by the IVR system, or later during data preparation.

• In instances where a response to a screener question is not obtained, the screener question and any questions in the skip pattern should be coded as M (Missing). For example, if the respondent does not provide an answer to question 10 of the HCAHPS questionnaire, then the IVR system may be programmed to skip to question 11, and automatically code question 11 as M (Missing).

INTRO1 Hello, may I please speak to [SAMPLE MEMBER NAME]?

1. YES [GO TO INTRO2]

2. NO [REFUSAL]

3 NO, NOT AVAILABLE RIGHT NOW [SET CALLBACK]

IF ASKED WHO IS CALLING:

This is [INTERVIEWER NAME] calling from [DATA COLLECTION CONTRACTOR].  We are conducting a survey about healthcare.  I am calling to talk to [SAMPLE MEMBER NAME] about a recent healthcare experience.

IF ASKED WHETHER PERSON CAN SERVE AS PROXY FOR SAMPLE MEMBER:

For this survey, we need to speak directly to [SAMPLE MEMBER NAME]. Is [SAMPLE MEMBER NAME] available?

INTRO2 Hi, this is [OPERATOR NAME], calling from [DATA COLLECTION CONTRACTOR] on behalf of [HOSPITAL NAME]. I am calling today to talk to you about the care you got from [HOSPITAL NAME] during your hospital stay that ended around [DISCHARGE DATE]. [HOSPITAL NAME] is carrying out a survey to obtain information about the medical care that people receive in the hospital.

Let me tell you a little about the survey before we continue. You have been chosen as part of a random sample of people who were in the hospital recently. Your opinions are very important because they reflect the opinions of other people like you. The results of this survey will be used to provide information to people who have to choose a hospital. You may choose to do this interview or not. If you do choose to participate, your answers may be shared with your hospital for quality improvement purposes. Your decision to do the interview will not affect your health care or the benefits you get. Questions 1-22 in this survey are part of a national initiative to measure the quality of care in hospitals. The questions should take about 7 minutes to answer. {The number of minutes will depend on whether HCAHPS is integrated with hospital-specific questions.} Do you want to participate? Ok, then let’s begin.

S1 Our records show that you were discharged from [HOSPITAL NAME] on or about [DISCHARGE DATE]. Is that right?

1 YES [GO TO S2]

2 NO [GO TO INEL1]

3 DK [GO TO INEL1]

4 REF [GO TO INEL1]

S2: Thank you. You will now be connected to an automated interviewing system. If at any time you would like to speak with a live operator, please press [VENDOR SPECIFY] to be connected with someone.

MESSAGE 1: You have been successfully connected to the automated interviewing system. The survey will now begin. You may enter [VENDOR SPECIFY] at any time to return to the phone interviewer. If you cannot choose one of the response options after a particular question, please wait for further instruction.

Q1_INTRO Please answer the questions in this survey about your stay at this hospital. When thinking about your answers, do not include any other hospital stays. The first questions are about the care you received from nurses during this hospital stay.

Q1 During this hospital stay, how often did nurses treat you with courtesy and respect? Would you say never, sometimes, usually, or always?

For “Never”, press '1'

For “Sometimes”, press '2'

For “Usually”, press '3'

For “Always”, press '4'

M MISSING/DK

Q2 During this hospital stay, how often did nurses listen carefully to you? Would you say never, sometimes, usually, or always?

For “Never”, press '1'

For “Sometimes”, press '2'

For “Usually”, press '3'

For “Always”, press '4'

M MISSING/DK

Q3 During this hospital stay, how often did nurses explain things in a way you could understand? Would you say never, sometimes, usually, or always?

For “Never”, press '1'

For “Sometimes”, press '2'

For “Usually”, press '3'

For “Always”, press '4'

M MISSING/DK

Q4 During this hospital stay, after you pressed the call button, how often did you get help as soon as you wanted it? Would you say never, sometimes, usually, always, or I never pressed the call button?

For “Never”, press '1'

For “Sometimes”, press '2'

For “Usually”, press '3'

For “Always”, press '4'

For “I never pressed the call button”, press '9'

M MISSING/DK

Q5_INTRO The next questions are about the care you received from doctors during this hospital stay.

Q5 During this hospital stay, how often did doctors treat you with courtesy and respect? Would you say never, sometimes, usually, or always?

For “Never”, press '1'

For “Sometimes”, press '2'

For “Usually”, press '3'

For “Always”, press '4'

M MISSING/DK

Q6 During this hospital stay, how often did doctors listen carefully to you? Would you say never, sometimes, usually, or always?

For “Never”, press '1'

For “Sometimes”, press '2'

For “Usually”, press '3'

For “Always”, press '4'

M MISSING/DK

Q7 During this hospital stay, how often did doctors explain things in a way you could understand? Would you say never, sometimes, usually, or always?

For “Never”, press '1'

For “Sometimes”, press '2'

For “Usually”, press '3'

For “Always”, press '4'

M MISSING/DK

Q8_INTRO The next set of questions is about the hospital conditions.

Q8 During this hospital stay, how often were your room and bathroom kept clean? Would you say never, sometimes, usually, or always?

For “Never”, press '1'

For “Sometimes”, press '2'

For “Usually”, press '3'

For “Always”, press '4'

M MISSING/DK

Q9 During this hospital stay, how often was the area around your room quiet at night? Would you say never, sometimes, usually, or always?

For “Never”, press '1'

For “Sometimes”, press '2'

For “Usually”, press '3'

For “Always”, press '4'

M MISSING/DK

Q10_INTRO The next questions I have are about your experiences in this hospital.

Q10 During this hospital stay, did you need help from nurses or other hospital staff in getting to the bathroom or in using a bedpan?

For “Yes”, press '1'

For “No”, press '2' [GO TO Q12]

M MISSING/DK [GO TO Q12]

Q11 How often did you get help in getting to the bathroom or in using a bedpan as soon as you wanted? Would you say never, sometimes, usually, or always?

For "Never”, press '1'

For “Sometimes”, press '2'

For “Usually”, press '3'

For “Always”, press '4'

8 NOT APPLICABLE

M MISSING/DK

Q12 During this hospital stay, did you need medicine for pain?

For “Yes”, press '1'

For “No”, press '2' [GO TO Q15]

M MISSING/DK [GO TO Q15]

Q13 During this hospital stay, how often was your pain well controlled? Would you say never, sometimes, usually, or always?

For “Never”, press '1'

For “Sometimes”, press '2'

For “Usually”, press '3'

For “Always”, press '4'

8 NOT APPLICABLE

M MISSING/DK

Q14 During this hospital stay, how often did the hospital staff do everything they could to help you with your pain? Would you say never, sometimes, usually, or always?

For “Never”, press '1'

For “Sometimes”, press '2'

For “Usually”, press '3'

For “Always”, press '4'

8 NOT APPLICABLE

M MISSING/DK

Q15 During this hospital stay, were you given any medicine that you had not taken before?

For “Yes”, press '1'

For “No”, press '2' [GO TO Q18_INTRO]

M MISSING/DK [GO TO Q18_INTRO]

Q16 Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? Would you say never, sometimes, usually, or always?

For “Never”, press '1'

For “Sometimes”, press '2'

For “Usually”, press '3'

For “Always”, press '4'

8 NOT APPLICABLE

M MISSING/DK

Q17 Before giving you any new medicine, how often did hospital staff describe possible side effects in a way you could understand? Would you say never, sometimes, usually, or always?

For “Never”, press '1'

For “Sometimes”, press '2'

For “Usually”, press '3'

For “Always”, press '4'

8 NOT APPLICABLE

M MISSING/DK

Q18_INTRO The next questions are about when you left the hospital.

Q18 After you left the hospital, did you go directly to your own home, to someone else’s home, or to another health facility?

For “Own home” press '1'

For “Someone else's home”, press '2'

For “Another health facility”, press '3' [GO TO Q21]

M MISSING/DK [GO TO Q21]

Q19 During this hospital stay, did doctors, nurses or other hospital staff talk with you about whether you would have the help you needed when you left the hospital?

For “Yes”, press '1'

For “No”, press '2'

8. NOT APPLICABLE

M MISSING/DK

Q20 During this hospital stay, did you get information in writing about what symptoms or health problems to look out for after you left the hospital?

For “Yes”, press '1'

For “No”, press '2'

8 NOT APPLICABLE

M MISSING/DK

Q21 We want to know your overall rating of your stay at this hospital. Please do not include any other hospital stays in your answer.

Using any number from 0 to 10, where 0 is the worst hospital possible and 10 is the best hospital possible, what number would you use to rate this hospital?

Please press this number now.

Q22 Would you recommend this hospital to your friends and family? Would you say definitely no, probably no, probably yes, or definitely yes?

For “Definitely no”, press '1'

For “Probably no”, press '2'

For “Probably yes”, press '3'

For “Definitely yes”, press '4'

M MISSING/DK

Q23_INTRO This last set of questions is about you.

Q23 In general, how would you rate your overall health? Would you say that it is excellent, very good, good, fair, or poor?

For “Excellent”, press '1'

For “Very good”, press '2'

For “Good”, press '3'

For “Fair”, press '4'

For “Poor”, press '5’

M MISSING/DK

Q24 What is the highest grade or level of school that you have completed? Did you complete the 8th grade or less, complete some high school but did not graduate, graduate from high school or earn a GED, complete some college or earn a 2-year degree, graduate from a 4-year college, or complete more than a 4-year college degree?

For “Completed the 8th grade or less”, press '1'

For “Completed some high school, but did not graduate”, press '2'

For “Graduated from high school or earned a GED”, press '3'

For “Completed some college or earned a 2-year degree”, press '4'

For “Graduated from a 4-year college”, press '5'

For “Completed more than a 4-year college degree”, press '6'

M MISSING/DK

Q25 Are you of Spanish, Hispanic or Latino origin or descent? Would you say no, not Spanish/Hispanic/Latino; yes, Puerto Rican; yes, Mexican, Mexican American, Chicano; Yes, Cuban; or Yes, other Spanish/Hispanic/Latino

For “No, not Spanish/Hispanic/Latino”, press '1'

For “Yes, Puerto Rican”, press '2'

For “Yes, Mexican, Mexican American, Chicano”, press '3'

For “Yes, Cuban”, press '4'

For “Yes, other Spanish/Hispanic/Latino”, press '5'

M MISSING/DK

Q26 "What is your race? I will read you a list of choices. You may choose one or more.

Would you say that you are White?

For “Yes”, press '1'

For “No”, press '2'

M MISSING/DK

Would you say that you are Black or African-American?

For “Yes”, press '1'

For “No”, press '2'

M MISSING/DK

Would you say that you are Asian?

For “Yes”, press '1'

For “No”, press '2'

M MISSING/DK

Would you say that you are Native Hawaiian or other Pacific Islander?

For “Yes”, press '1'

For “No”, press '2'

M MISSING/DK

Would you say that you are American Indian or Alaska Native?

For “Yes”, press '1'

For “No”, press '2'

M MISSING/DK

NOTE: “1” and “2” SHOULD BE CONVERTED TO “1” AND “0”, RESPECTIVELY IN THE DATA FILE. FOR VALID VALUES, REFER TO APPENDIX O—CAHPS HOSPITAL SURVEY DATA FILE STRUCTURE.

Q27 "What language do you mainly speak at home? Would you say that you mainly speak English, Spanish, or some other language?

For “English”, press '1'

For “Spanish”, press '2'

For “Some other language”, press '3'

M MISSING/DK

END1 Those are all the questions I have. Thank you for your time. Have a good (day/evening).

POSSIBLE INELIGIBLE RESPONDENTS

INEL1: Were you ever at this hospital?

1. YES [GO TO INEL2]

2. NO [GO TO END2]

INEL2: Were you a patient at this hospital in the last year?

1 YES [GO TO INEL3]

2 NO [GO TO END2]

INEL3: When was this?

IF ANY PERIOD WAS WITHIN TWO WEEKS OF [DISCHARGE DATE], GO TO S2; OTHERWISE, GO TO END2.

END2: Thank you for your time. It looks like we made a mistake. I apologize for taking up your time. Have a good (day/evening).

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