Emergency Department CAHPS (ED CAHPS)

Background: The emergency department (ED) is a unique environment within the health care system, bridging the worlds of outpatient and inpatient care. In particular, the ED is a pivotal arena for the provision of acute care services. In 2017, there were nearly 139 million emergency room visits in the United States. Further, under EMTALA – the Emergency Medical Treatment and Active Labor Act of 1986 – everyone who comes to a hospital-based ED for care is entitled to a screening exam and stabilizing treatment (including hospitalization, if needed) without regard to ability to pay, making the ED a resource for those who may have no other place to receive care.

About the ED CAHPS Survey: As the leading organization spearheading national implementation of patient experience of care surveys, CMS has made considerable investments in developing and testing the Emergency Department Consumer Assessment of Healthcare Providers and Systems (ED CAHPS) Survey.  In 2012, CMS launched an initiative to develop a reliable, valid, standardized survey to measure patients’ experience of ED care that would provide meaningful and actionable information for EDs. The survey development process followed the principles and guidelines outlined by the Agency for Healthcare Research and Quality (AHRQ) and its CAHPS Consortium in developing a patient experience of care survey. The ED CAHPS Survey is designed for adult patients (18 and older) of hospital-based emergency rooms who are discharged to home (also known as “treat and release” visits), which account for about 90% of all ED visits. The ED CAHPS Survey includes 35 questions that focus on communication and coordination, including arrival at the ED, care during the ED visit, and discharge from the ED; the survey also includes key demographic items.  

The ED CAHPS survey, which is in the public domain and available at no cost, allows EDs to collect information about their patients’ experience of care and identify aspects of care that could be improved. On its web site, CMS provides the ED CAHPS Survey and detailed recommendations on how EDs can implement, administer and score the survey; please see below.  Use of the ED CAHPS Survey is entirely voluntary and is not required by CMS.

The ED CAHPS Survey was designed to be administered several ways: a mail survey with telephone follow-up of non-respondents; a web-based survey with telephone follow-up; or a web-based survey with mail and then telephone follow-up. These “mixed modes” of survey administration can best capture the wide range of patients that EDs serve. The ED CAHPS Survey Recommended Guidelines includes templates and detailed specifications for implementing each survey mode; please see below.    

ED CAHPS Survey Supporting Materials: Provided below are links to the ED CAHPS Survey and the recommended guidelines for implementation, administration and scoring. Please note that earlier versions of the survey were called the Emergency Department Patient Experience of Care (EDPEC) Survey. This survey received the CAHPS trademark in March 2020, and was then renamed the ED CAHPS Survey. To maintain continuity, below we provide links to earlier versions of the survey, findings from its mode experiment and field tests, and relevant publications by the EDPEC Project Team (now known as the ED CAHPS Project Team). For more information, please contact: ED_Survey@cms.hhs.gov

Please note that the ED CAHPS Survey development and testing occurred before the COVID-19 pandemic.

EDPEC Publications by the EDPEC Project Team

Mathews M, Parast L, Elliott MN, Lehrman WG, Stark D, Waxman D (2023). Associations Between Emergency Severity Index and Patient Experience of Care in the Emergency Department. Academic Emergency Medicine, 30 (1). https://onlinelibrary.wiley.com/doi/10.1111/acem.14604.

Tolpadi A, Elliott MN, Waxman D, Becker K, Flow-Delwiche E, Lehrman WG, Stark D, Parast L (2022). National Travel Distances for Emergency Care. BMC Health Services Research, 22 (388). https://doi.org/10.1186/s12913-022-07743-7. 

Ye F, Parast L, Hays RN, Elliott MN, Becker K, Lehrman WG, Stark D, Martino D (2021). Development and Validation of a Patient Experience of Care Survey for Emergency Departments. Health Services Research. https://doi.org/10.1111/1475-6773.13853.

Chen PG, Tolpadi A, Elliott MN, Hays R, Lehrman WG, Stark DS, Parast L (2021). Gender Differences in Patients’ Experience of Care in the Emergency Department. Journal of General Internal Medicine. https://link.springer.com/article/10.1007/s11606-021-06862-x.

Parast L, Mathews M, Martino S, Lehrman WG, Stark D, Elliott MN (2021). Racial/Ethnic Differences in Emergency Department Utilization and Experience. Journal of General Internal Medicine, 36 (4). https://link.springer.com/article/10.1007/s11606-021-06738-0.

Parast L, Mathews M, Elliott MN, Tolpadi A, Flow-Delwiche E, Lehrman WG, Stark D, Becker K (2019). Effects of Push-To-Web Mixed Mode Approaches on Survey Response Rates: Evidence from a Randomized Experiment in Emergency Departments. Survey Practice, 12(1): 10.29115/SP-2019-0008.

Mathews M, Parast L, Tolpadi A, Elliott MN, Flow-Delwiche E, Becker K (2019). Methods for Improving Response Rates in an Emergency Department Setting - A Randomized Feasibility Study. Survey Practice, 12(1): 10.29115/SP-2019-0007.                                                                                                                                   

Parast L, Mathews M, Tolpadi A, Elliott MN, Flow-Delwiche E, Becker K (2019). National Testing of the Emergency Department Patient Experience of Care (EDPEC) Discharged to Community (DTC) Survey and Implications for Adjustment in Scoring. Medical Care, 57(1): 42-48.

Weinick RM, Becker K, Parast L, Stucky BD, Elliott MN, Mathews M, Chan C, Kotzias V (2014). Emergency Department Patient Experience of Care Survey: Development and Field Test. RAND Corporation, RR-761-CMS.