October
9, 2003
For Immediate Release
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Contact:
Richard Deutsch
202-331-5790 Ext. 313 |
Supporting
The National Voluntary Hospital Reporting Initiative
Statement
by AHQA Executive Vice President David Schulke The
national network of Quality Improvement Organizations (QIOs) strongly
endorses the goals of the National Hospital Voluntary Reporting Initiative
and is committed to the success of this effort by the nation’s hospital
leaders.
The initiative
took a step forward today with the posting of the first round of hospital
performance data on the Centers for Medicare and Medicaid Services (CMS)
web site. Although only about 400 hospitals posted data on the site today,
more than 1000 hospitals—one quarter of all eligible U.S. hospitals—are
expected to have data posted by February 2004. That’s a credible
start for an ambitious effort.
The potential
impact of the initiative is enormous. The initiative will inform the public
and health care providers on how well individual hospitals adhere to widely
accepted evidence-based guidelines for the treatment of heart attacks,
heart failure, and pneumonia. We know from scientific studies that adherence
to these guidelines lowers mortality. Studies have also shown that publishing
valid comparative performance data motivates physicians and other health
care professionals to improve.
As more
data is made public, certain trends bear watching. Our initial analysis
of the data just posted to the CMS site, reveals:
- Hospitals
vary tremendously in the quality of service they provide, suggesting
that the industry is not yet using a systematic approach to reliably
provide excellent care.
- Quality
of care also varies within institutions. For example, many hospitals
that do a great job at heart care don’t do as well preventing
and treating community-acquired pneumonia. This suggests that it is
not yet possible to select a reliably excellent health care team simply
by choosing a hospital.
- Even
many above-average institutions have a long way to go to provide reliably
excellent care.
- Doctors
and consumers should ask those hospitals not yet reporting to make their
data public. Hospitals should consider asking for help from their local
QIO so they can get the benefit of others’ experience in improving
care.
Under contract
to the Centers for Medicare and Medicaid Services (CMS), QIOs have been
helping hospitals since 1998 measure performance according to national
clinical guidelines and adopt proven “best” practices for
heart care and treatment of pneumonia. Since 2002, QIOs also have been
working with hospitals on the prevention of surgical site infections.
These efforts
are paying off. A study published in JAMA earlier this year showed improvement
on 20 out of 22 measures of clinical quality of care for seniors between
1998 and 2001—with strong gains in providing medication to prevent
a second heart attack and in rapid treatment of pneumonia with the right
antibiotics. But the pace of such improvement can and should be much quicker.
The voluntary hospital reporting initiative draws attention to the need
for faster improvement and will help focus hospital efforts on meeting
national clinical care guidelines.
CMS has
funded QIOs to help hospitals in Arizona, Maryland, and New York test
a new standardized “patient experience of care” survey (H-CAHPS);
develop effective methods for communication of performance data to consumers;
and promote the use of clinical performance and data for consumer decision-making.
Hospitals working with QIOs in these states will serve as test sites for
performance reporting on a broader set of clinical measures.
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