CMS-10543 EDPEC Survey Telephone Script

Attachment 5 - EDPEC Survey Telephone Script- all versions
TELEPHONE SCRIPT
Overview
This telephone interview script is provided to assist interviewers while attempting to reach the
patient. The script explains the purpose of the survey and confirms necessary information about
the patient. If assigned to the no-proxy allowed group, the interviewer must interview the
sampled patient only.
General Interviewing Conventions and Instructions
• The telephone introduction script must be read verbatim.
• All text that appears in lowercase letters must be read out loud
• Text in UPPERCASE letters must not be read out loud
• However, YES and NO response options are to be read if necessary
• All questions and all answer categories must be read exactly as they are worded
• All transitional statements must be read
• Text that is underlined must be emphasized
• Characters in < > must not be read
• [Square brackets] are used to show programming instructions that must not actually
appear on telephone interviewing system screens
• MISSING/DON’T KNOW (DK) is a valid response option for each item in the script.
This allows the interviewer to go to the next question if a patient 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 - Missing/Don't know.”
• Skip patterns should be programmed into the telephone interviewing system.
o Appropriately skipped questions should be coded as “8 - Not applicable.” For
example, if a patient answers “No” to Question 10 of the HCAHPS survey, the
program should skip Question 11, and go to Question 12. Question 11 must then be
coded as “8 - Not applicable.” Coding may be done automatically by the telephone
interviewing system or later during data preparation.
o When 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/Don't know.” For
example, if the patient does not provide an answer to Question 10 of the HCAHPS
survey, then the telephone interviewing system should be programmed to skip
Question 11, and go to Question 12. Question 11 must then be coded as “M Missing/Don't know.” Coding may be done automatically by the telephone
interviewing system or later during data preparation.

NOTE: SEE INTERVIEWING GUIDELINES IN APPENDIX I FOR GUIDELINES ON
HOW TO HANDLE DIFFICULT TO REACH PATIENTS.
INITIATING CONTACT
START

Hello, may I please speak to [SAMPLED PATIENT NAME]?
1
YES [GO TO INTRO]
2
NO [REFUSAL]
3
NO, NOT AVAILABLE RIGHT NOW [SET CALLBACK]

<1> YES SPEAKING WITH SAMPLED PATIENT– [GO TO INTRO]
<2> YES SPEAKING WITH PROXY –[GO TO INTRO1A]
<3>NO – [GO TO INTRO2]
<4> DON’T KNOW/REMEMBER – [GO TO INTRO2]
<5> REFUSE – [GO TO REFUSAL MODULE]
<6> ALREADY RETURNED SURVEY BY MAIL [GO TO MAILED MODULE]
<7> PATIENT DIDN’T RECEIVE CARE AT NAMED ED OR HOSPITAL [GO TO
INELIGIBLE MODULE]

IF ASKED WHO IS CALLING:
This is [OPERATOR NAME] calling from [DATA COLLECTION
CONTRACTOR] on behalf of [HOSPITAL NAME]. We are conducting a survey
about healthcare. Is [SAMPLED PATIENT NAME] available?
PROGRAMMER DISPLAY THIS FOR NON PROXY GROUP:
IF ASKED WHETHER PERSON CAN SERVE AS PROXY FOR SAMPLED
PATIENT:
For this survey, we need to speak directly to [SAMPLED PATIENT NAME]. Is
[SAMPLED PATIENT NAME] available?
PROGRAMMER DISPLAY THIS FOR PROXY GROUP:
IF ASKED WHETHER PERSON CAN SERVE AS PROXY FOR SAMPLED
PATIENT:
For this survey, we can speak with [SAMPLED PATIENT NAME] or we can
speak with person who knows most about the care [SAMPLED PATIENT
NAME] received. Is [SAMPLED PATIENT NAME] available?

IF THE SAMPLED PATIENT/ IDENTIFIED PROXY IS NOT AVAILABLE:
Can you tell me a convenient time to call back to speak with (him/her)?
IF THE SAMPLED PATIENT/ IDENTIFIED PROXY SAYS THIS IS NOT A
GOOD TIME:
If you don’t have the time now, when is a more convenient time to call you back?
IF ASKED IF YOU WOULD LIKE TO SPEAK TO “SR.” OR “JR.”: I would
like to speak with [SAMPLED PATIENT] who is approximately [AGE RANGE].

2

SPEAKING WITH SAMPLED PATIENT
INTRO

PROGRAM OPTIONS DEPENDING ON TYPE OF PATIENT AND
PROXY/NON PROXY
PROGRAMMER: DISPLAY THIS IF SAMPLED PATIENT ADMITTED
TO HOSPITAL:
Hi, this is [OPERATOR NAME], calling on behalf of [HOSPITAL NAME].
[HOSPITAL NAME] is participating in a survey about the care people receive in
the hospital. This survey is part of a national initiative to measure the quality of
care in hospitals. Survey results can be used by people to choose a hospital. Your
answers may be shared with the hospital for purposes of quality improvement.
Participation in the survey is completely voluntary and will not affect your health
care or your benefits. It should take between 8 and 15 minutes to answer.
This call may be monitored [recorded] for quality improvement purposes.

PROGRAMMER DISPLAY THIS IF SAMPLE PATIENT DISCHARGED
TO COMMUNITY:
Hi, this is [OPERATOR NAME], calling on behalf of [HOSPITAL NAME].
[HOSPITAL NAME] is participating in a survey about the care people receive in
the emergency room. This survey is part of a national initiative to measure the
quality of care in emergency rooms. Survey results can be used by people to
choose an emergency room. Your answers may be shared with the hospital for
purposes of quality improvement.
Participation in the survey is completely voluntary and will not affect your health
care or your benefits. It should take about 10 minutes to answer.
This call may be monitored [recorded] for quality improvement purposes.
PROCEED TO S1
IF SPEAKING WITH PROXY
INTRO1A

PROGRAMMER: DISPLAY THIS IF SAMPLED PATIENT ADMITTED TO
HOSPITAL:

Hi, this is [INTERVIEWER NAME] calling on behalf of [HOSPITAL NAME].
[HOSPITAL NAME] is participating in a survey about the care people receive in
the hospital. [SAMPLE PATIENT] gave us your name and indicated that you
were knowledgeable about the care he/she received. This survey is part of a
national initiative to measure the quality of care in hospitals. Survey results can be

used by people to choose a hospital. Your answers may be shared with the
hospital for purposes of quality improvement.
Participation in the survey is completely voluntary and will not affect your health
care or your benefits. It should take about 10 minutes to answer.
This call may be monitored [recorded] for quality improvement purposes.

PROGRAMMER
DISPLAY
THIS
IF
SAMPLED
PATIENT
DISCHARGED TO COMMUNITY:
Hi, this is [OPERATOR NAME], calling on behalf of [HOSPITAL NAME].
[HOSPITAL NAME] is participating in a survey about the care people receive in
the emergency room. [SAMPLE PATIENT] gave us your name and indicated that
you were knowledgeable about the care he/she received in the emergency room.
This survey is part of a national initiative to measure the quality of care in
emergency rooms. Survey results can be used by people to choose an emergency
room. Your answers may be shared with the hospital for purposes of quality
improvement.
Participation in the survey is completely voluntary and will not affect your health
care or your benefits. It should take about 10 minutes to answer.
This call may be monitored [recorded] for quality improvement purposes.
PROCEED TO S1

IF ADMITTED TO HOSPITAL:
S1
Our records show that you were discharged from [HOSPITAL NAME] on or
about [DISCHARGE DATE]. Is that right?
IF SPEAKING WITH PROXY: Our records show that [sampled patient name
was] discharged from [HOSPITAL NAME] on or about [DISCHARGE DATE].
Is that right?
READ YES/NO RESPONSE CHOICES ONLY IF NECESSARY
1
2
3
4

YES
NO
DON’T KNOW
REFUSAL

IF DISCHARGEDTO COMMUNITY:

4

[GO TO S2]
[GO TO INEL1]
[GO TO INEL1]
[GO TO INEL1]

S1

Our records show that you visited the emergency room at [HOSPITAL NAME]
on or about [ED VISIT DATE]. Is that right?
IF SPEAKING WITH PROXY: Our records show that [sampled patient name]
visited the emergency room at [HOSPITAL NAME] on or about [ED VISIT
DATE]. Is that right?
READ YES/NO RESPONSE CHOICES ONLY IF NECESSARY
1
2
3
4

YES
NO
DON’T KNOW
REFUSAL

[GO TO S2]
[GO TO INEL1]
[GO TO INEL1]
[GO TO INEL1]

CONFIRMING INELIGIBLE RESPONDENTS
PROGRAMMER: DISPLAY APPROPRIATE TEXT DEPENDING ON PATIENT TYPE AND
PROXY/NON PROXY:
INEL1:

IF ADMITTED TO HOSPITAL:
Were you ever at this hospital?
IF PROXY: Was [SAMPLED PATIENT NAME] ever at this hospital?
1
YES [GO TO INEL2]
2
NO
[GO TO INEL_END]
IF DISCHARGED TO COMMUNITY:
Were you ever in the emergency room at this hospital?
IF PROXY: Was [SAMPLED PATIENT NAME] ever in the emergency room at
this hospital?
3
YES [GO TO INEL2]
4
NO
[GO TO INEL_END]

INEL2:

Were you a patient at this hospital in the last year?
IF PROXY: Was [SAMPLED PATIENT NAME] at this hospital in the last year?
1
2

INEL3:

YES
NO

[GO TO INEL3]
[GO TO INEL_END]

When was this?
FOR ADMITTED PATIENTS: IF ANY DATE WAS WITHIN TWO WEEKS
OF [DISCHARGE DATE], GO TO S2; OTHERWISE, GO TO INEL_END.
FOR DISCHARGED TO COMMUNITY: IF ANY DATE WAS WITHIN TWO
WEEK OF [ED VISIT DATE] GO TO S2, OTHERWISE GO TO INEL_END.

S2:

Thank you. Let’s begin the survey.

PROGRAMMER NOTE:
GO TO APPROPRIATE SURVEY INSTRUMENT THAT THIS CASE HAS BEEN
RANDOMIZED INTO.

INEL_END: Thank you for your time. It looks like we made a mistake. Have a good
(day/evening).

BEGIN SURVEY QUESTIONS
END

6

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