In an effort to continue progress toward a safer health care system through improving patient safety and reducing hospital admissions, CMS has released a Request for Proposal (RFP) for Hospital Improvement and Innovation Networks (HIINs). The HIINs, which will be part of the Quality Improvement Organization (QIO) initiative, will continue the good work started by the Hospital Engagement Networks (HENs) under the Partnership for Patients initiative. These organizations will tap into the experience, capabilities and impact of QIOs, hospital associations, hospital systems, and national hospital affinity organizations with extensive experience in hospital quality improvement. The HIINs will engage and support the nation’s hospitals, patients, and their caregivers in work to implement and spread well-tested, evidence-based best practices.
In a commentary for the Journal of the American Medical Association, Medicare officials write that common misperceptions persist regarding the role of Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys. Used properly, HCAHPS scores can be a valuable tool in the quest to improve patient experience and accounts for 30 percent of a hospital’s Total Performance Score (TPS) under the Hospital Value-Based Purchasing program. The report states while there is concern expressed that patient satisfaction is given too much weight relative to other measures, a CMS analysis indicates no single HCAHPS measure can throw off a hospital’s scores by itself.
An AHRQ-funded contract to develop and pilot test a prototype for capturing patient-reported patient safety events has demonstrated that such a system is challenging but feasible. Researchers were able to capture information on safety events from the patient and family perspective – a viewpoint that has previously been unavailable to hospitals and others. Most patient safety event reporting systems capture information from the clinician or provider perspective. Including the patient perspective gives patient safety experts a more complete understanding of the event that happened. The Health Care Safety Hotline was developed and implemented in two hospital systems over 15 months. A total of 37 reports were successfully submitted by patients.
Interesting Health Affairs Blog post on whether hospitals help or hinder a better report card. Rather than waiting for actions from the federal government, the author states there are significant actions hospitals could take to build a better report card right now, the biggest opportunity lies in data reliability and timeliness.
Four National Health Plans, One Regional Plan Sign Joint Letter Urging Hospitals to Publicly Report Vital Safety, Quality Performance DataMartina Dolan | May 20, 2016
Four national health plans and one regional plan have signed a joint letter urging hospitals to publicly report vital safety and quality performance data by participating in the 2016 Leapfrog Hospital Survey. Aetna, Anthem, Inc., Cigna, UnitedHealthcare and Health Net of California all signed the letter, which was sent last week to over 3,700 hospitals across the country. The plans are part of the Leapfrog Partners Advisory Committee, an exclusive group of national and regional health plans, hospital systems, and enterprise vendors that advise Leapfrog on key industry trends and collaborate on a number of partner-driven initiatives.
AHA News writes: Medicare patients admitted to critical access hospitals for common surgical procedures are no more likely to die within 30 days than similar patients at other hospitals and have lower complication rates and expenditures, according to a study published today in the Journal of the American Medical Association. The study compared Medicare admissions for four common surgical procedures: appendectomy, gall bladder removal, removal of all or part of the colon, and hernia repair. Patients undergoing surgery at CAHs were less likely to have chronic medical problems and serious complications (6% vs 14%). After adjusting for patient differences, the 30-day mortality rate for CAHs and non-CAHs was not significantly different (5.4% vs 5.6%). Medicare expenditures adjusted for patient factors and procedure type were lower at CAHs than non-CAHs ($14,450 vs $15,845). The findings “contrast previously published literature about nonsurgical admissions in these same settings and inform legislators about the valuable role critical access hospitals provide in the U.S. health care system,” the authors said.
- AHA News: http://news.aha.org/article/160517-study-cah-surgical-outcomes-at-least-as-good-as-other-hospitals
- Association of Hospital Critical Access Status With Surgical Outcomes and Expenditures Among Medicare Beneficiaries. JAMA The Journal of the American Medical Association
The Washington Post writes the latest effort by the federal government in measuring medical quality in hospitals – the combining of dozens of metrics into one patient-friendly quality indicator – is proving the most contentious. Hospital leaders who previewed the preliminary rating system say the formula is skewed against institutions that treat the poorest or toughest patients, meaning those with complex illnesses. The number of stars would be based on 64 different measures, which CMS has posted on Medicare’s Hospital Compare website. The metrics on mortality, readmission, patient experience and patient safety are the most influential, each representing 22 percent of a facility’s rating. Consumer advocates defend the rating system, saying that while not perfect, it correctly reflects higher rates of problems in some big institutions despite their lofty reputations.
Leapfrog Group Issues a Response to Research Findings that Public Reporting Measures Fail to Describe the True Safety of HospitalsMartina Dolan | May 13, 2016
The Leapfrog Group issued a response to the article published this week in the journal Medical Affairs (see blog post http://blogs.ipro.org/abouthealthtransparency/2016/05/13/research-finds-public-reporting-measures-fail-to-describe-the-true-safety-of-hospitals) to clarify the measures used in the Hospital Safety Score and how these measures relate to the study’s findings.
Since the launch of the Hospital Safety Score in 2012, Leapfrog has worked with a volunteer panel of patient safety experts to develop and update the methodology for the Hospital Safety Score. All measures included in the Score are publicly available and have gone through rigorous scientific testing. Most are endorsed by the National Quality Forum. For the last four years, The Hospital Safety Score Expert Panel has advised Leapfrog to include three Hospital-acquired Conditions (HACs) and seven Patient Safety Indicators (PSIs) among the 30 measures used to calculate the Hospital Safety Score composite.
While the Leapfrog Group and their Expert Panel agree that, like all measures, the measures used in the Hospital Safety Score are not perfect, they believe they represent the best assessment of patient safety available today, and provide consumers with meaningful information to assist in choosing a hospital. All 30 measures meet exceptionally high standards for integrity and Leapfrog stands behind them.
Common measures used by government agencies and public rankings to rate the safety of hospitals do not accurately capture the quality of care provided, new research from the Johns Hopkins Armstrong Institute for Patient Safety and Quality suggests.
The findings, published in the journal Medical Care, found only one measure out of 21 met the scientific criteria for being considered a true indicator of hospital safety. The measures evaluated in the study are used by several public rating systems, including U.S. News and World Report’s Best Hospitals, Leapfrog’s Hospital Safety Score, and the Center for Medicare and Medicaid Services’ (CMS’) Star Ratings. The Johns Hopkins researchers say their study suggests further analysis of these measures is needed to ensure the information provided to patients about hospitals informs, rather than misguides, their decisions about where to seek care.
- Validity of the Agency for Health Care Research and Quality Patient Safety Indicators and the Centers for Medicare and Medicaid Hospital-acquired Conditions: A Systematic Review and Meta-Analysis. Medical Care.
Interesting article in Healthcare Finance on the rise in importance of hospital safety rankings, and how denial within facility and to the public leads to the growth of an unhealthy culture and harmful public mistrust. Consumers are paying far closer attention to public hospital grades – such as the recently released Spring 2016 Leapfrog Patient Safety Grades – because they are shouldering increasingly larger portions of their healthcare costs, and are far more scrutinizing in where they spend those dollars, writes the author, and denial is the last thing a poorly marked hospital should do.