Tag Archives: hospital quality

More hospitals reporting quality data from EHRs but these data are not available by facility

Rebecca Vesely

About Rebecca Vesely

Rebecca Vesely is AHCJ’s topic leader on health information technology and a freelance writer. She has written about health IT since the late 1990s for a variety of publications.

Photo” PINKÉ via Flickr

The number of hospitals voluntarily submitting data on quality generated by electronic health records (EHRs) increased significantly over the past year, according to the Joint Commission, a leading health care facility accreditation organization.

However, these data are not publicly available by facility, according to the Joint Commission. This is unfortunate because the information offers another window into hospital quality. AHCJ has long advocated for the public release of the Joint Commission’s hospital accreditation surveys and complaint reports. Continue reading

As consumers see more hospital ‘report cards,’ reporters can explain their limitations

Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at healthjournalism.org. She welcomes questions and suggestions on health reform resources and tip sheets at joanne@healthjournalism.org. Follow her on Facebook.

At Health Journalism 2012, Harvard’s Ashish K. Jha, M.D., M.P.H.,  told attendees to  watch for new hospital report cards from The Leapfrog Group that were going to be both comprehensive and consumer-friendly. Jha and some other top health quality/safety people were among the project’s advisers.

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People can understand letter grades – A through F. The idea is that a comprehensive approach – an overall grade – is more useful in the sense that, if a hospital gives fabulous and safe cardiac care, it doesn’t mean that a patient won’t get an avoidable infection during, say, a routine hernia operation or have a cesarean section that wasn’t unambiguously necessary.

Well, it turns out that the ratings aren’t just a tool in the whole consumer/quality movement. Some of the links at the end of this post can tell you more about the limits of these proprietary report cards versus public data – but consumers are seeing more and more of these “report cards” and you can use them for stories too. Continue reading

Disclosure of hospital infections still in its infancy

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

On Forbes.com, Gergana Koleva evaluated the woeful state of national hospital-associated infection reporting, with the help of recently published research. As Koleva writes, such infections account for more than 8,000 deaths each year in the United States and add an estimated $10 billion in annual cost, and hospitals routinely collect valuable data on such things for internal use, yet no clear reporting standards exist on a national level.

The report … shows that only 21 states currently have legislation that requires monitoring and public reporting for surgical site infections. Of those, only eight states actually make the data publicly available, and only a total of 10 procedures – out of 250 possible types of surgeries – get reported.

And even many those states that reported some surgical infection rates as of late 2010 (Colorado, Massachussetts, Missouri, New York, Ohio, Oregon, South Carolina, and Vermont)

Continue reading

Dallas reporters use AHRQ data to measure patient safety

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

The Dallas Morning News continues its 19-month investigation into patient safety at UT Southwestern Medical Center and Parkland Memorial Hospital.

The project, “First, Do No Harm: An investigation of patient safety in Dallas hospitals,” is behind the website’s paywall but The Dallas Morning News has granted AHCJ members access. To find out how to access the stories, please click here and log in as an AHCJ member.

Among the latest reporting:

Dallas Morning News reporters Ryan McNeill and Daniel Lathrop took advantage of AHRQ’s Patient Safety Indicator (PSI) software, typically used internally by hospitals, to process 9 million publicly available patient records from Texas hospitals, all of which came from between

Parkland, the prominent local hospital that has earned scrutiny on numerous prior occasions, was just the most notable of a number of area hospitals that came up short (and generated headlines), but our interest lies more with the reporters’ investigative methodology as well as the path they’ve blazed for broader hospital quality reporting.

All their work was done in consultation with experts in the field, including academics, government officials and hospital administrators. An outside review indicated McNeill and Lathrop used the software properly, and their results were in line with a similar public analysis. But that’s not to say it was a simple process.

The newspaper spent six months analyzing nearly 9 million state hospital discharge records using Patient Safety Indicators, or PSI, software. This highly sophisticated system was designed for the federal government as a tool to measure potentially preventable complications among hospital patients.

The PSIs do not present a complete safety picture because they are based on administrative data — a summary of diagnoses, procedures and outcomes derived from patients’ medical charts, as opposed to a complete review of all medical records.

It’s not a perfect measure, but it’s one of the best available.

PSIs “reflect quality of care inside hospitals,” according to the Agency for Healthcare Research and Quality, a division of the U.S. Department of Health and Human Services. It released the PSI software in 2003 and periodically updates it, most recently in August. The News used that version for its final analysis.

The software analyzes the administrative data that nearly every hospital in Texas reports to the state. No patient-identifying information is included.

The results on 15 PSIs are statistically “risk-adjusted” because some hospitals treat a disproportionate share of unhealthy patients, who face a greater risk of potentially preventable complications. Rates from eight of the indicators are used to determine a hospital’s patient safety “composite score.”

The AHRQ has just started posting some PSI measures on Hospital Compare, and the Texas health department plans to follow suit in 2013, but reporters looking to get their hands on a broader swath of the data will still have to follow the Dallas duo’s do-it-yourself approach.

The reporters’ work drew criticism from the Texas Hospital Association, which said the methodology was “not intended for use in public reporting.” McNeill refutes its claims in a blog post. Daniel K. Podolsky, president of UT Southwestern Medical Center, also sent a letter criticizing the reporting. George Rodrigue, managing editor of The Dallas Morning News, published a point-by-point response to Podolsky’s letter.

Data shows disconnect between patient perception, hospital performance

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

Sifting through Medicare hospital rating data, USA Today reporters Steve Sternberg and Christopher Schnaars found an enlightening disconnect between patients’ subjective ratings of hospitals and hospital performance on quantitative measures such as death and readmission rates.

“This is a very important finding,” says Donald Berwick, director of the Centers for Medicare & Medicaid Services, adding that though patient-survey data offer critical insights into how it feels to be a patient at different hospitals, patients’ perceptions don’t tell the whole story.

The story is packaged with an infographic that allows readers to look up ratings for local hospitals.

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