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Jack Schnelle, Ph.D.
Jack Schnelle, Ph.D.
Q: At a Brookings Institute hearing last month, you said the survey system probably sets unrealistic care standards. Why?

A: There has been no valid resource analysis on what is necessary to meet these standards.

Q: Provider attitudes play a role, right?

A: Providers do not perceive the survey system to be objective, important or transparent.

Q: How do surveyors perceptions fit in?

A: There are instructions to surveyors about measuring actual care through observation but these instructions are vague. There is no evidence that surveyors are ever trained to the point that they can look at the same care situation and agree on quality conclusions, (which is) kind of a fundamental principle of measurement.

Q: And you think that's the key to doable survey reform?

A: There are well-developed rules of measurement. They have simply not been applied to the survey quality assessment system. That can make an immediate difference in the consistency and accuracy of the survey process. Providers would be motivated to apply these same accurate measurement protocols to pass the survey, and there is an excellent chance that care would be improved.
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