I read an excellent blog by Robert Heinlein recently, who discussed how HCAHPS scores could be raised with Patient Education.
I agree with Robert that educating our patients - and managing their expectations - is an overlooked, and fundamental aspect of improving HCAHPS scores.
I say 'overlooked' because as clinicians, our first reaction is solve the problem with a clinical solution. We review processes, fine-tune systems, look for root causes, embark on sophisticated training and communications programs, etc, when sometimes a simpler fix may be all that's required.
Case in point is a small mid-western hospital I just visited, who was struggling with patient satisfaction scores in their ED that were less than what their patients (clearly) desired - but were clearly miles ahead of national averages in several key metrics.
...the disconnect? Misaligned expectations. Simple to fix, but often, it takes an outside pair of eyes to help see it.