Veterans’ Feedback Needed from Health Care Surveys

VA Southern Nevada Healthcare System is constantly evolving the way it provides care based on feedback from Veterans themselves. Shortly after a visit to a VASNHS hospital or clinic, Veterans may receive a survey that asks them about their visit. These can come in two forms: a SHEP or V-Signals survey.

The Survey of Healthcare Experience of Patients (SHEP) provides information to facility managers about the Veteran experience. Feedback includes ease and speed of making an appointment, experience with their provider, followed up with blood test or x-ray results, and if medications were discussed. Veterans can receive this survey through post mail or email, and typically arrives two weeks after your appointment or discharge from inpatient care.

SHEP surveys focus on four health care areas: inpatient care, primary care, specialty care and care in the community. The survey information and other data, such as wait times, staffing data, direct observation or talking to patients, help to generate a robust picture of facility health and areas for improvement.

Nationally, all health care is evaluated under a program called CAHPS (Consumer Assessment of Healthcare Providers and Systems.) This program helps health care systems to evaluate their care in three areas. First, patients' perspectives of care that allow objective and meaningful comparisons of hospitals on topics that are important to consumers. Second, public reporting of the survey results creates new incentives for hospitals to improve quality of care. Third, public reporting serves to enhance accountability in health care by increasing transparency of the quality of hospital care provided in return for the public investment. These are also some of the key drivers that impact Veteran trust in the quality of care.

SHEP shows us where we stand among health care providers within our community and across the nation. By maintaining what is good and focusing improvement measures on problem areas, we expect ratings to improve over time. The quarterly reports provide gains or losses based on the previous reporting period.

The VA Office of Quality and Patient Safety, Analytics and Performance Integration Division, Office of Performance Measurement, conducts SHEP surveys.

The second survey that the VA relies on for Veteran feedback about their care is V-Signals. A V-Signals survey is given at random shortly after a Veteran finishes their appointment. A link to the V-Signals survey is sent to the Veteran via a text message or email. This allows the Veteran to provide real-time feedback and is shorter in length than the SHEP survey. Results are shared with VASNHS Veterans Experience staff within 5-10 mins of survey submission. Currently V-Signals surveys are provided for Outpatient appointments, but plans are in place for Inpatient appointments to be eligible for V-Signals surveys in the near future.

VASNHS Chief of Public Affairs Charles Ramey says SHEP and V-Signals surveys impact the Veteran experience and improve clinical health outcomes in profound ways. “If we don’t know how we’re doing, we don’t know where to focus our efforts to improve care. The more people we hear from, the more reliable our information is and the more confident we are that we are looking in the right places and taking the right actions.”

In the case of both surveys, Veterans’ participation is paramount to their success. VA nationwide averages about a 35% response rate. This indicates many Veterans invest in their own health care and appreciate having a voice in improving it. The number of patients surveyed varies based on the size of the facility and the type of care sought.

Ramey believes these surveys are an important component of VASNHS becoming a trusted care provider. “Focusing on those moments that matter increases a Veterans understanding and ability to manage their health post-discharge. Good patient experience is good medicine. By giving them a good patient experience and always looking to improve it, we are giving them the skills and knowledge needed to stay healthy.”