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Inside the program: Use of percentiles as a goal

HCPro's Weekly Update on the ANCC Magnet Recognition Program®*, April 26, 2010

Many hospitals use percentiles provided by their satisfaction survey vendors as their patient satisfaction goal (e.g., to be in the 90th percentile). Percentiles are a way of measuring comparative performance, rather than absolute performance, as they are based on how the hospital ranks compared to the other hospitals in the vendor database. The percentiles are based on a comparison with the hospitals in the pool.

Therefore, the size of the comparison group, as well as the quality of the other hospitals in that group, will have a substantial effect on the hospital’s percentiles. For example, hospitals with the same HCAHPS results may be in a high percentile in one vendor’s database and in a much lower percentile in another vendor’s database. Before using vendor percentiles as a goal, consider whether the comparison group the vendor is using is large enough and whether it contains the types of hospitals you want to emulate.

You also may have the option of setting up a custom comparison group with your vendor so you can compare yourself to the performance of hospitals of similar size, type, region, and so forth. If you are interested in using historical national performance to set your percentile goals, the Commonwealth Foundation has created a Web site (www.whynotthebest.org) that enables hospitals to identify the national top 25%, 10%, and 1% for each of the 10 publicly reported Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) measures, as well as to see what their ranking is on each measure. The site is based on the data publicly reported on the Centers for Medicare & Medicaid Services’ (CMS) Hospital Compare Web site; however, it is several months old. HCAHPS vendors may have percentiles based on more recent performance.

Source: HCAHPS Basics: A Resource Guide for Healthcare Managers

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