Physicians use consumer guide' to improve quality
Physicians use consumer guide’ to improve quality
Data differences often due to normal variation
While physician groups and hospitals are concerned about published ratings, how much they can influence their scores may depend largely on what is measured and how well they are already doing.
For example, the Cleveland Clinic regularly scores well on such items as patient satisfaction in the Cleveland Health Quality Choice reports, which are sponsored by an independent business/medical coalition and compiled semiannually by Quality Information Management Corp., a nonprofit entity. Yet the public doesn’t see the raw scores in the newspaper. They view a chart that tells them whether hospitals scored better than expected, the same as expected, or lower than expected. If the Cleveland Clinic, a large group practice that includes 1,000 hospital beds and other health care services, is expected to score well, then the chart simply shows a sideways arrow. Expected levels of satisfaction are based on area norms and variations in patient population, such as health status, education level, and health insurance.
"Generally, the satisfaction surveys show the patients are very happy with the physicians," says Penny Ott, MS, MPA, administrator of the office of quality management at the Cleveland Clinic. In raw scores, which are included in the full report, the variation among hospitals is small, she says. "It’s always going to be kind of a random opportunity of who’s going to look good this month or next month," she says.
Still, the Cleveland Clinic conducts its own in-depth patient satisfaction surveys, in part to improve the patient satisfaction scores measured by the Cleveland Health Quality Choice Coalition. For example, the Cleveland Clinic determined that it needed to take a broader view of patient education, Ott says. While patients were pleased with the disease-specific educational material they received, they had other, simpler information needs, she says.
"What we realized when we probed is that they’re already satisfied with [the medical] information," she says. "What they want to know is, When I’m in this hospital bed, what are you going to do today? Where are you taking me? What time am I going to see my doctor?’ We got a different perspective on patient information."
Some departments of the Cleveland Clinic have used focus groups to delve into specific issues of patient satisfaction. Others have examined processes to determine, for example, just what contributes to delays that annoy patients.
"The presence of something like Cleveland Health Quality Choice, because it’s so competitive [as published comparative information], will make you look at how you can do better," Ott says. "The tools they use to [present] that may not be the best tools. There’s going to be some good to come out of it even though it’s flawed."
[Editor’s note: The Cleveland Health Quality Choice summary report can be ordered for $5 by sending a check and mailing address to: Summary Report Booklet, Quality Information Management Corporation, 1127 Euclid Ave., Suite 741, Cleveland, OH 44115. Telephone: (216) 696-7999.]
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