Proceedings of the 2016 Winter Simulation Conference T. M. K. Roeder, P. I. Frazier, R. Szechtman, E. Zhou, T. Huschka, and S. E. Chick, eds. THE IMPACT OF SYSTEM FACTORS ON PATIENT PERCEPTIONS OF QUALITY OF CARE David P. Dzubay Eduardo Pérez Ingram School of Engineering Department of Industrial Engineering Texas State University 601 University Dr. San Marcos, TX 78666, USA ABSTRACT The Hospital Value-Based Purchasing (VBP) Program is a Center for Medicare and Medicaid Services (CMS) initiative that rewards hospitals with incentive payments for the quality of care they provide to patients with Medicare instead of the quantity of procedures they perform. Although the VBP program has direct implications toward both patients and hospitals, no research has been reported in the literature addressing how hospitals can enhance patients’ experience of care. This research uses systems modeling to improve the patient experience of care considering the eight dimensions in the Hospital VBP. A case study is presented that considers three intensive care units from a hospital located in central Texas. The simulation results show that strategies such as having a quick patient discharge process greatly benefit the hospital in terms of how patients perceive quality of care as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. 1 INTRODUCTION Delivering patient-centered care is an important component of a high-quality healthcare system (Baker 2001). In 2010 the Hospital Value-Based Purchasing (VBP) was established to link Medicare’s payment system to a value-based system that focuses on the patient. Under the VBP, healthcare systems are evaluated not only on the patient outcomes but also on the patient experience of care while in the hospital. The VBP program uses the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey to measure patient experience of care. The results of the survey are used to incentivize hospitals that perform according to the VBP goals. The best hospital performers are incentivized up to 1% of their annual earnings. That incentive amount is expected to double by 2017. Therefore, it is imperative for hospitals to consider new strategies to serve patients while considering both, patient outcomes and patient experience of care. The HCAHPS survey is a 27-part questionnaire that is currently used as the standard tool to quantify patient’s experience. The survey takes into account eight different dimensions including nurse communication, doctor communication, cleanliness and quietness, responsiveness of hospital staff, pain management, communication about medicine, discharge information, and overall rating. Currently, we know little about the relationship between hospital performance and patient satisfaction (Tsai et al. 2015). As national policy efforts, such as VBP are implemented, understanding the potential tradeoffs between patient satisfaction and measures of efficiency of hospital system factors become very important. In this paper, a discrete-event simulation is developed to model the patient interactions with doctors and nurses in three intensive care units (ICUs) of a hospital located in Central Texas. The objective of the study is to provide insights about the impact of hospital system factors on the patient experience of care as measured by the HCAPHPS survey. The system factors considered in this study include patient 978-1-5090-4486-3/16/$31.00 ©2016 IEEE 2169 Authorized licensed use limited to: Texas State University. Downloaded on August 11,2025 at 05:34:42 UTC from IEEE Xplore. Restrictions apply.