Quality Update for September 23, 2003

NCQA: Quality Gaps Contribute To 57,000 Deaths Federal Task Force To Hold Second Patient Safety Research Summit AMA-Backed Firm To Help Individuals Monitor Diabetes Online CA Ranks Hospitals On Heart Bypass Surgery Mortality Rates JCAHO, NQF Announce 2003 John Eisenberg Award Winners NCQA: Quality Gaps Contribute To 57,000 Deaths A new report by the National Committee for Quality Assurance said 57,000 people die needlessly each year because of quality gaps in the health care system, most notably a failure to translate medical research findings into practice. The report found a number of problems, including limited use of technology, inadequate payment systems, and failures to deliver appropriate care. The report, The State of Health Care Quality: 2003, said the deaths are the result of errors of omission, as opposed to medical mistakes. NCQA said there are massive variations in the rates at which certain important medical therapies and treatments are delivered. The report said that health plans measuring and reporting on their performance, showed a higher level of clinical quality. But across the country only 40% of the 31 million Americans diagnosed with high blood pressure have their blood pressure adequately controlled, the report said. If 68% had their blood pressure controlled—which the top health plans achieved—an estimated 28,000 lives would be saved, NCQA calculated. The report said health care quality gaps also are taking a financial toll. NCQA attributed 41 million sick days to the health care system’s failure to appropriately treat just five conditions—asthma, depression, diabetes, heart disease, and high blood pressure. In addition, the report said that hospitalizations due to avoidable second heart attacks cost the American economy more than $1.6 billion annually. For more info, www.ncqa.org. Back to top Federal Task Force To Hold Second Patient Safety Research Summit The Quality Interagency Coordination Task Force, which was established by the White House in 1998 to better coordinate efforts by various federal agencies to improve health care quality, will hold its second national summit on patient safety research on Nov. 7 in Arlington, VA. Participants will review the status of patient safety research stemming from the organization’s first summit in September 2000, explore ways to translate research findings into effective patient safety improvements, and develop priorities for future patient safety research. The conference is seeking reports and comments on the following topic areas: Epidemiology of Patient Safety Risks and Hazards: Identification of medical errors and causes of patient injury in health care delivery, with a focus on populations that are vulnerable because they are compromised in their ability to function as engaged patients during health care delivery. Effective Practices and Tools: Development and field testing of patient safety practices to identify practices that are effective, appropriate, and feasible for health care organizations to implement, taking into account the level of evidence needed to assess patient safety practices. Infrastructure for Effective Practices: Establishment of the health care structural and environmental elements needed for successful implementation of effective patient safety practices, including an organization's commitment and readiness to improve patient safety (e.g., culture, information systems), hazards to safety created by the organization's structure itself (e.g., physical configurations, procedural requirements), and effects of the macro-environment on the organization's ability to act (e.g., legal and payment issues). Broader Adoption of Effective Practices: The adoption, implementation, and institutionalization of improved patient safety practices to achieve sustainable improvement in patient safety performance across the health care system. Monitoring Progress and Maintaining Vigilance: Establishment and monitoring of indicators to assess performance improvement progress for key patient safety processes or outcomes, while maintaining continued vigilance to ensure timely detection and response to issues that represent patient safety risks and hazards. For more info, www.rand.org/health/conferences/summit. Back to top AMA-Backed Firm To Help Individuals Monitor Diabetes Online Medem Inc., a for-profit Internet company supported by the American Medical Association and other medical societies, has launched a new service that will allow patients and their doctors to monitor diabetes online. The new tool allows patients to load blood-glucose levels stored on their meters on to a secure server, which is then downloaded by their doctors. Connecticare, a managed-care company in Farmington, Conn., is making the service available to about 150 patients starting next month. The firm will determine whether the Medem tool results in better care to diabetics and lowers health-care costs, and plans to pay physicians an annual monitoring fee for each patient, said company officials. Medem officials said it is also in discussions with other insurers about making the service available through their networks. For more info, www.medem.com. Back to top CA Ranks Hospitals On Heart Bypass Surgery Mortality Rates California hospitals providing a higher volume of heart bypass surgeries tend to have lower mortality rates, according to a new state survey. The California Report on Coronary Artery Bypass Graft Surgery is the second report issued in a collaborative effort between the state government and the Pacific Business Group on Health, the San Francisco-based employer group. The report is based on data collected from 1997 through 1999, which is frustrating for many patients and providers who would like more recent data. “The public ought to be outraged by this,” Dr. Robert Brook, of the UCLA School of Public Health and chairman of the technical advisory committee for the heart surgery report, told the San Francisco Chronicle. “The usefulness of the information is really limited by how old it is… This is last century’s data.” However, Dr. Brook, in the article, praised the report for adjusting for the severity of illness among patients treated at each hospital—recognizing that those that treat sicker patients will have a higher death rate, which is not a reflection of poor quality. The report compared death rates after bypass surgery among 70 hospitals in the state that voluntarily submitted data of the three-year period of 1997-99. The statewide average death rate during that period was 2.76%. This year, all 113 hospitals where heart bypass surgery is performed in California are required by a new state law to submit data for a similar report. That data will be released in 2005. For more info, www.oshpd.state.ca.us/HQAD/HIRC/Outcomes/CABG/index.htm. Back to top JCAHO, NQF Announce 2003 John Eisenberg Award Winners The National Quality Forum (NQF) and the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) announced the 2003 recipients of the annual John M. Eisenberg Patient Safety Awards. Honorees were selected in three of the four Award categories and include: Individual Lifetime Achievement: Jeffrey Cooper, Massachusetts General Hospital, Boston, MA, for his application of human factors research to anesthesia machine safety and for later pioneering the concept of critical incident analysis. Advocacy (one national and one local recipient): The Leapfrog Group, Washington, DC for developing national purchaser consensus around a series of focused patient safety goals and leveraging their implementation in hospitals. Lehigh Valley Hospital and Health Network, Allentown, PA, for its advocacy and commitment to multi-disciplinary systems approaches, specifically the active engagement of health care consumers and the community, to reduce preventable adverse events in the delivery of health care. System Innovation: Abington Memorial Hospital, Abington, PA, for the creation of “The Virtual Anticoagulation Clinic,” which reduced the morbidity and mortality of patients taking anticoagulant medications. The patient safety awards program—launched in 2002 by NQF and JCAHO—honors John M. Eisenberg, M.D., who was a widely respected administrator of the Agency for Healthcare Research and Quality (AHRQ) before his death last year. For more info, www.jcaho.org. Back to top

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