CMS-10102 OMB2007 - Telephone Script_English

CAHPS^ Hospital Survey

Telephone Script

(English)

CAHPS^® Hospital Survey Telephone Script (English)

Overview

This telephone 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. 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 electronic telephone interviewing system screens.

• MISSING/DON’T KNOW (DK) is a valid response option for each item in the computerized telephone interviewing system scripts. This allows the telephone interviewer 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 computerized telephone interviewing 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 telephone interviewing system or later during data preparation.

• In instances where an interviewer is unable to obtain a response to a screener question, the screener question and any questions in the skip pattern should be coded as M (Missing). For example, if an interviewer selects <MISSING/DK> to question 10 of the HCAHPS questionnaire, then the telephone interviewing 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 [INTERVIEWER 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

<2> NO [GO TO INEL1]

<3> DK [GO TO INEL1]

<4> REF [GO TO INEL1]

Q1_INTRO Please answer the questions in this survey about this stay at [HOSPITAL NAME]. 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…

1. Never,

2. Sometimes,

3. Usually, or

4. Always?

<M> MISSING/DK

Be prepared to probe if the respondent answers outside of the Categories provided. Probe using the answer categories only; do not interpret for the respondent.

Q2 During this hospital stay, how often did nurses listen carefully to you? Would you say…

1. Never,

2. Sometimes,

3. Usually, or

4. Always?

<M> MISSING/DK

Q3 During this hospital stay, how often did nurses explain things in a way you could understand? Would you say…

1. Never,

2. Sometimes,

3. Usually, or

4. Always?

<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…

1. Never,

2. Sometimes,

3. Usually,

4. Always, or

<9> I never pressed the call button.

<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…

1. Never,

2. Sometimes,

3. Usually, or

4. Always?

<M> MISSING/DK

Q6 During this hospital stay, how often did doctors listen carefully to you? Would you say…

1. Never,

2. Sometimes,

3. Usually, or

4. Always?

<M> MISSING/DK

Q7 During this hospital stay, how often did doctors explain things in a way you could understand? Would you say…

1. Never,

2. Sometimes,

3. Usually, or

4. Always?

<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…

1. Never,

2. Sometimes,

3. Usually, or

4. Always?

<M> MISSING/DK

Q9 During this hospital stay, how often was the area around your room quiet at night? Would you say…

1. Never,

2. Sometimes,

3. Usually, or

4. Always?

<M> MISSING/DK

Q10_INTRO The next questions 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?

1. YES

2. NO [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…

1. Never,

2. Sometimes,

3. Usually, or

4. Always?

<8> NOT APPLICABLE

<M> MISSING/DK

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

<1> YES

<2> NO [GO TO Q15]

<M> MISSING/DK [GO TO Q15]

Q13 During this hospital stay, how often was your pain well controlled? Would you say…

1. Never,

2. Sometimes,

3. Usually, or

4. Always?

<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…

1. Never,

2. Sometimes,

3. Usually, or

4. Always

<8> NOT APPLICABLE

<M> MISSING/DK

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

<1> YES

<2> NO [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…

1. Never,

2. Sometimes,

3. Usually, or

4. Always?

<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…

1. Never,

2. Sometimes,

3. Usually, or

4. Always?

<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?

<1> OWN HOME

<2> SOMEONE ELSE’S HOME

<3> ANOTHER HEALTH FACILITY [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?

<1> YES

<2> NO

<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?

<1> YES

<2> NO

<8> NOT APPLICABLE

<M> MISSING/DK

Q21 We want to know your overall rating of your stay at [FACILITY NAME]. This is the stay that ended around [DISCHARGE DATE]. 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 during your stay?

<00>

<01>

<02>

<03>

<04>

<05>

<06>

<07>

<08>

<09>

<10>

<M> MISSING/DK

Q22 Would you recommend this hospital to your friends and family? Would you say…

<1> Definitely no,

<2> Probably no,

<3> Probably yes, or

<4> Definitely yes?

<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…

<1> Excellent,

<2> Very good,

<3> Good,

<4> Fair, or

<5> Poor?

<M> MISSING/DK

Q24 What is the highest grade or level of school that you have completed? Did you ..

<1> Complete the 8^th grade or less,

<2> Complete some high school, but did not graduate,

<3> Graduate from high school or earn a GED,

<4> Complete some college or earn a 2-year degree,

<5> Graduate from a 4-year college, or

<6> Complete more than 4-year college degree?

<M> MISSING/DK

ACADEMIC TRAINING BEYOND A HIGH SCHOOL DIPLOMA THAT DOES NOT LEAD TO A BACHELORS DEGREE SHOULD BE CODED AS 4. IF THE RESPONDENT DESCRIBES NON-ACADEMIC TRAINING, SUCH AS TRADE SCHOOL, PROBE TO FIND OUT IF S/HE HAS A HIGH SCHOOL DIPLOMA AND CODE 2 OR 3, AS APPPROPRIATE.

Q25 Are you of Spanish, Hispanic or Latino origin or descent? Would you say…

<1> No, not Spanish/Hispanic/Latino,

<2> Yes, Puerto Rican,

<3> Yes, Mexican, Mexican-American, Chicano,

<4> Yes, Cuban, or

<5> Yes, other Spanish/Hispanic/Latino?

<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… [CODE ALL THAT APPLY]

<1> White,

<2> Black or African-American,

<3> Asian,

<4> Native Hawaiian or other Pacific Islander, or

<5> American Indian or Alaska Native?

<M> MISSING/DK

NOTE: IN THE SURVEY FILE LAYOUT, THIS QUESTION IS BROKEN INTO FIVE SEPARATE FIELDS TO ALLOW CODING OF MULTIPLE RESPONSES TO THIS QUESTION. 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…

<1> English,

<2> Spanish, or

<3> Some other language? [GO TO Q27A]

Q27A What other language do you mainly speak at home?

<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 Q1; 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).