The Quality Initiative A Public Resource on Hospital Performance August 2003
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Transcript of The Quality Initiative A Public Resource on Hospital Performance August 2003
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The Quality Initiative
A Public Resource onHospital Performance
August 2003August 2003
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Honoring Our Commitments• Our commitments:
To give the best care we know how to give Foster a relationship of caring and trust with each
patient Foster a relationship of caring and trust with the
communities we serve
• The dilemma: The public gets little information on quality Hospitals are inundated with requests for data
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The Quality Initiative
Create a shared national strategy for quality
measurement and public accountability
ObjectiveObjective
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The Quality Initiative
• Share useful information with the public
• Prioritize measurement areas• Standardize measurement
specifications• Facilitate predictable measurement
reporting• Reduce duplication
GoalsGoals
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The Quality Initiative
• Voluntary reporting - Start with 10 measures of 3 conditions Acute myocardial infarction Congestive heart failure Pneumonia
• Add patient perception of care measures• Add more clinical measures - IOM priority
conditions• Support performance improvement
AgreementAgreement
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Starter Set of Clinical Measure
• AMI (heart attack) Aspirin at arrival Aspirin at discharge Beta-Blocker at arrival Beta-Blocker at
discharge ACE Inhibitor for LVSD
• Heart Failure Left ventricular function
assessment ACE Inhibitor for LVSD
• Pneumonia Initial antibiotic
timing Pneumococcal
vaccination Oxygenation
assessment
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IOM Priority Areas of Focus• Care Coordination• Self-Management/
Health Literacy• Asthma• Cancer Screening• Children w/ Special Health Care
Needs• Diabetes• End of Life Care for those with
major organ failure• Frailty with Old Age • Hypertension• Immunizations • Ischemic Heart Disease
• Major Depression • Medication Management• Nosocomial Infections• Pain Control in Advanced
Cancer• Pregnancy and Childbirth• Severe and Persistent
Mental Illness• Stroke• Tobacco Dependence• Obesity
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Partners• AHA, AAMC, FAH• CMS• AHRQ• JCAHO• National Quality Forum• AFL-CIO• AARP• Nat’l Assoc of Children's Hospitals• The Disclosure Group• AMA
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New Developments
Pledged EligibleParticipants Hospitals %
Total Hospitals 1503 4,279 35.1%Number of Beds 323,559 840,494 38.5%Admissions 14,157,731 34,233,973 41.4%
Participation - HospitalsParticipation - Hospitals
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Public Release of Data• September 2003 as information
for health professionals ---- www.cms.hhs.gov
• Summer 2004 as information for the public ---- www.medicare.gov
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Endorsements
State Hospital Associations Endorsing the Initiative
State Hospital Associations Engaged in CMS Pilot Project
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Next Steps
• Needed to round out quality picture• Hospital CAHPS tool created by
CMS and AHRQ• Being pilot tested in AZ, MD, NY• AHA View --- should address 8
aspects of care, including patient perspectives on safety
Patient Perspectives of CarePatient Perspectives of Care
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AHA View
• Allow hospitals to incorporate into existing patient surveys
• Flexibility in administration, but comparability first
• Continuous data collection• Conduct survey within 45 days of
discharge• Adjust for patient differences
Patient Perspectives of CarePatient Perspectives of Care
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Strategic Issues• Broaden agreement on single data
collection and reporting Necessary so hospitals can accommodate more
measures• Add measures
Start with IOM priorities, but get broad input Move ahead rapidly, but only after attain
consensus on measures• Increase hospital participation
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The Quality InitiativeThe Quality Initiative
A Public Resource onA Public Resource onHospital PerformanceHospital Performance
August 2003August 2003