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Consumer-friendly language aids comparisons
As previously reported by Healthcare Benchmarks and Quality Improvement, hospital executives are paying more attention every day to report cards and other comparative data that provide information about hospital quality.
With the launch of a new tool called Quality Check, from the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), it has become even more apparent they are wise to do so.
Using a database that compares more than 16,000 local hospitals, home care agencies, nursing homes, laboratories, and ambulatory care organizations, Quality Check offers consumers the ability to compare health care information about the quality and safety of care provided in an accredited health care organization with others on state and national bases.
"We hope this will take the guesswork [out of choosing a hospital]," said Dennis S. O’Leary, MD, president of JCAHO, during a recent news conference announcing the launch of Quality Check. "It includes new information about thousands of health care facilities and how their individual performance compares nationally and statewide."
For example, he noted, if patients want to know about heart failure treatment, "They can compare different facilities in doing things experts agree improve outcomes."
Or in terms of safety, they can see if the facility complies with hand hygiene guidelines, O’Leary added. "You can see if they take a time-out before surgery to ensure they are doing the right procedure on the right body part on the right patient," he observed.
At present, Quality Check compares facilities in four major conditions: heart attack, heart failure, pneumonia, and pregnancy-related conditions. Individuals also will be able to determine how health care organizations compare with others in meeting national requirements that help them prevent medical accidents.
The requirements specifically seek to avoid misidentification of patients, surgery on the wrong body part, miscommunication among caregivers, unsafe use of infusion pumps, medication mix-ups, problems with equipment alarm systems, and infections acquired in the health care setting.
These incorporate JCAHO’s National Quality Improvement Goals, as well as National Patient Safety Goals. Other information available to the consumer includes:
How it works
When an individual goes to the Quality Check site, he or she can select the search function either for consumers or for health care professionals.
"We try providing layers of information, from the high level down to as much information as you want," explained Evelyn Lockett Woods, executive vice president for support operations and chief information officer for JCAHO, while demonstrating the use of the site during the conference.
"On the professional side, we provide things such as benchmarks. On the consumer side, we use language for the lay public," she says.
"I applaud JCAHO’s effort to make more information available, easy to use and to understand," noted Kenneth W. Kizer, MD, MPH, president and chief executive officer of the National Quality Forum (NQF).
Kizer said he was pleased the commission was using NQF’s endorsed measures where they could be used, and that it had "publicly committed to continue to expand and use them as they become available.
"I’m hopeful the AHA [American Hospital Association] and others in the voluntary hospital reporting initiative will make a similar commitment as well," Kizer pointedly added.
Consumers can obtain a wealth of information about a selected hospital. On the first page, they can select "type of provider" and narrow their search by state, county, and zip code. Having picked a facility, they can request a quality report, which includes an index of all the information they can find.
In comparisons against national averages in all the aforementioned categories, consumers will see either a plus ("this organization performs significantly better than other organizations"), a minus ("this organization performs significantly lower than other organizations"), or a check (the hospital is "within the pack").
Hospitals also can be compared, for example, to the top 10% or top 50% in a given category.
"You can drill down farther," Lockett Woods explained. "Say you are looking at pneumonia: You can double-click to specific measures that led to [the plus, minus, or check] — like adult smoking cessation programs."
It also will show the number patients treated and the percentage who received such education. Similarly, it can show how often a best practice procedure is followed. A star indicates the best possible result.
Consumer friendliness praised
Several conference participants praised the commission for making Quality Check user-friendly.
"When people are making these choices, they want to feel safe and confident," noted Judith Hibbard, DrPH, a professor in the department of planning, public policy, and management at the University of Oregon.
"Often, such things are not written in a way a nonmedical person can understand. This, however, is understandable and easy to use. It helps consumers learn what they should be looking for when they choose a hospital," she said.
"We view this as an important step toward engaging employers and consumers in health care quality, added Suzanne F. Delbanco, PhD, chief executive officer of The Leapfrog Group.
Noting that "very few consumers know how to spend their health care dollars wisely," Debra L. Ness, president of the National Partnership for Women & Families, called Quality Check "a good start," but added that more is needed.
"We still need data from a broader range of conditions, about more outcomes of care, and better ways of discerning among providers, and how to assess the cost-effectiveness of treatment," she asserted.
Hibbard predicted still another benefit from the launch. "Our research shows making performance public increases QI efforts and performance improvement," she observed. "This can also be an important motivator for hospitals to improve quality of care."
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