Background

A key element of the Aligning Forces for Quality (AF4Q) program has been the collection and use of data on the quality—and more recently, the costs—of care delivered by physicians, medical practices, and other providers of ambulatory care. To achieve that goal, the Alliances have implemented various strategies to identify performance measures that offer information that community stakeholders value, make that information available, and encourage health care providers, consumers, employers, insurers, and policymakers to use it to improve care.

Since its inception, the AF4Q program has explicitly called for the inclusion of measures of patient experience with ambulatory care alongside measures of clinical quality and safety. Over time, the expectations of the Alliances evolved, from early objectives of educating stakeholders about patient experience surveys and assessing the feasibility of surveying on a community level to current goals of integrating patient experience survey results into quality improvement initiatives.

This document summarizes some of the central lessons learned across the 16 Alliances about implementing and using the CAHPS Clinician & Group Survey (CG-CAHPS), a widely accepted tool for measuring patient experience with ambulatory care, developed by the Agency for Healthcare Research and Quality.[1] The lessons are organized into three major areas:

• Implementing CG-CAHPS measures of patient experience community wide.
• Public reporting of performance on these measures.
• Use of CG-CAHPS measures to stimulate improvement.

These three areas are interconnected. For example, public reporting on performance often creates interest among organizations in initiating efforts to improve their patients’ experiences with care. At the same time, organizations that improve care over time (and see evidence of that improvement publicly reported) tend to be highly motivated to maintain and expand efforts to collect and report measures of patient experience.